Contents
Greetings..............................................................................................3
Organizational Framework...................................................................6
Acknowledgement................................................................................9
General Information and Social Program...........................................10
Meetings, Pre and Related Conference.............................................12
Instruction for Oral Speakers and Session Chairpersons...................13
Instruction for Poster Presentation.....................................................15
Floor Plan...........................................................................................16
Poster Layout.....................................................................................18
Exhibitors............................................................................................19
Makuhari Map.....................................................................................20
Program at a Glance..........................................................................21
Full Program.......................................................................................25
August 18 (Sunday)...................................................................25
August 19 (Monday)..................................................................26
August 20 (Tuesday).................................................................33
August 21 (Wednesday)............................................................39
Poster Program..................................................................................43
Abstract..............................................................................................69
Author Index.....................................................................................213

1

Greeting
Good occasion to learn from achievements of advanced countries in Tobacco Control

Japan hosted the 3rd conference of APACT in 1993 held in Omiya City, Saitama
Prefecture, and 20 years have passed since then. Marked achievements in
tobacco control have been obtained during this period, in particular, unanimous
adoption of FCTC in the World Health Assembly in 2003 and it came into effectsince 27 February 2005. All countries of the world have been trying to improvetheir tobacco control based on FCTC, however, its speed markedly differsfrom country to country. One of most advanced countries in tobacco control isAustralia, and they succeeded in a plain package of cigarette.
One of the areas least developing in many member countries might be prevention of passive
smoking, which was first alerted by Dr. Takeshi Hirayama of Japan in 1981, then confirmed by several
studies carried out in several countries in later years. Japan is far behind in this regard, and we have toaccelerate the control of passive smoking much faster than before, learning from experiences of advanced
countries in tobacco control.
In this 10th APACT conference, nearly all topics of tobacco control were adopted either in plenary
sessions or in symposia including scientific presentations and practical problems in tobacco control, andmany interesting trials are presented in a poster session. I, myself, have been a specialist in tuberculosis.
As clear evidences were found on the ill-effect of tobacco on tuberculosis, it is my concern how to integrate
tobacco control into tuberculosis control program as smoking seems to be rather popular among TB
patients, in particular, in developing countries.
August in Japan is one of the hottest seasons in Japan, not only hot in temperature, but also humid,
but the conference hall is well air-conditioned, and hot discussions are expected during the conference.
As a president of 10th APACT conference, I cordially wish you to enjoy your stay in Japan.

Dr. Tadao Shimao
President, the 10th APACT Conference
President, Japan NGO Council on Tobacco or Health
Advisor, Japan Anti-Tuberculosis Association

3

GreetingWelcome to Japan.
On behalf of the Japan Society for Tobacco Control (JSTC), we welcome you to
APACT 2013. This APACT is held in collaboration with the 7th annual conferenceof the JSTC.
JSTC is the largest society of its kind in Japan, and now has more than 3,000
members acting together to fully implement the FCTC in our country, with the help
of FCA and SEATCA.

Manabu Sakuta, M.D.
Vice President of APACT Japan
Board Chairman of the JSTC,
Professor

On this occasion of APACT, we would like to learn more about the ill effects of
tobacco and the tobacco industry, and how to overcome them.
Let’s begin by exchanging each of our experiences.
Cooperation is the key slogan that we have to pursue.

Japan ratified FCTC in June, 2004 and FCTC has come into force since
February 27, 2005. Since then some progress has been made in Japan, suchas reimbursement of smoking cessation treatment by health insurance (April,
2006) and about 40% increase of tobacco tax/price (October, 2010). Smoking
prevalence among adults as well as adolescents has been gradually declining.
However, as shown in the MPOWER 2013 published on July 10, Japan has notmade any steps in the area of P (Protection people from tobacco smoke), W

Akira Oshima, M.D.
Vice President of APACT Japan
President of Japan Medical-Dental
Association for Tobacco Control(Warn about the dangers of tobacco, anti-tobacco mass media campaign) andE (Enforce bans in tobacco advertising, promotion and sponsorship). During thesession of this APACT 2013, many speeches about achievements and ways toovercome obstacles in implementing FCTC will be presented and discussed. We
are sure to find good examples of evidence-based tobacco control in Asia-Pacificregion, and by learning from them we hope we will be able to make a steady andsubstantial progress in tobacco control toward tobacco-free Japan.
Sincerely,4Greeting

Hisayoshi Fujiwara,
M.D. PhD
Chairperson of ScientificCommittee

It is my pleasure to welcome you to Scientific Sessions in the 10th APACT
Conference 2013 held in an exciting new venue, Makuhari, Chiba, Japan.
The APACT meeting offers a unique opportunity to gather with colleagues fromaround Asia pacific areas, consisting of 40 countries, in an exciting educational
and professional environment. The scope and quality of the sclentific exchange
make Scientific Sessions the premier anti-smoking research and instructional
meeting. Programming this year will continue to center on 15 multidisciplinary
anti-smoking cores, consisting of 19 symposiums and 4 plenary lectures (oralsessions), in addition to 291 poster sessions. The 15 cores include:• Two protections from exposure to tobacco smoke • Four illness-specific issues •Women and tobacco use • Roles of nurses and other professionals • Treatment of
tobacco dependence • Education, communication, training and public awareness• Price and taxations • Other forms of tobacco/substances • Litigation/ regulationof the contents of tobacco products • Tobacco industry and corporate social
responsibility • Packaging and labeling of tobacco products, • Issues of trade andtobacco market opening • Protection of public health policies from commercial• Inequities in tobacco use and tobacco control • APACT Youth for the future
demandWe hope you have the opportunity to experience the enhancements to ourmeeting. Most importantly, we hope the meeting addresses the greater missionof the APCT.

The conference theme this year is “Ending the Tobacco Epidemic – Protecting
and Keeping Healthy Lives –” and highlights the grave missions of all the people
and parties fighting for the health of all people on earth.
In order to materialize this theme, we, the planning committee, decided to follow
the full implementation of the WHO Framework of the Convention on Tobacco
Control as a core of all conference sessions, so that every topic of the session is
directly and essentially related to it.
Thus, the conference accommodates two opening lectures, three plenary lectures,

Toru Mori, M.D.
Chairperson of Planning
Committee

twelve symposia, three luncheon seminars, and several satellite seminars/
symposia during four days. There will also be a venue for active participation of awider audience in the poster sessions that also feature FCTC spirits.
We are pleased to see that the conference is warmly supported by many scientists
and citizens who will join our programs, representing countries/areas throughout
Asia-Pacific and around the globe, as well as various organizations fighting
against tobacco. We sincerely hope that we will be able to discuss, exchange,
and network with old and new colleagues from more than 40 countries/areas,
strengthening our commitment to our global efforts toward a tobacco-free world.

5

Organizational Framework
Organizers (APACT Japan)

Japan Anti-Tuberculosis Association

Japan Society for Tobacco Control

日本禁煙推進医師歯科医師連盟

たばこと健康問題 NGO 協議会

Japan Medical-Dental Association for Tobacco Control

Japan NGO Council on Tobacco or HealthOperating organizations
Honorary Presidents:

Honorary Vice-Presidents:

President:
Vice-Presidents:

Planning Committee
Committee Chairperson:
Committee Vice-Chairperson:
Committee Members:

Scientific Committee
Committee Chairperson:
Committee Vice-Chairperson:
Committee Members:

6

President of the Japan Medical Association
President of the Japan Dental Association
President of the Japan Pharmaceutical Association
President of the Japanese Nursing Association
President of the Chiba Medical Association
President of the Chiba-ken Dental Association
President of the Chiba Pharmaceutical Association
President of the Chiba Nursing Association
Tadao Shimao
Manabu Sakuta
Akira Ohshima

Toru Mori
Manabu Sakuta
Masataka Kato
Masakazu Nakamura
Takashi Noda
Hiroshi Yamato
Reiko Saito
Takeko Yamashita
Noriko Hiraga
Takahiro Suzuki
Mikio Kawamata

Hisayoshi Fujiwara
Manabu Sakuta
Ryohei Adachi
Makishige Asano
Tomoyuki Goya

Takeo Uchida
Kyoichi Miyazaki
Takao Hanioka
Yumiko Mochizuki
Tadao Shimao
Bungaku Watanabe
Masako Shigeta
Hiroyasu Muramatsu

Kenji Amagai
Shuji Dohi
Junkichi Hama

Hitoshi Aoyama
Ichiro Fukumoto
Nobuyuki Hamajima

Takashi Hanioka
Naofumi Hayabuchi
Yoko Hirota
Koji Inagaki
Ritsu Katayama
Fumitaka Kikkawa
Michiyuki Matsuzaki
Toru Mori
Takashi Nakano
Takashi Noda
Misaki Ohmori
Yoneatsu Osaki
Yoshihisa Saida
Manabu Sakuta
Kazunori Shimada
Naoyuki Sugano
Osami Tokudome
Makiko Yamamoto
Masayuki Yokode

Hisashi Harada
Jitsuo Higaki
Tamaki Hosomi
Yoshiki Ishii
Masataka Kato
Hirokatsu Kinoshita
Kazuko Mitoku
Seiji Morioka
Yoshiko Nakata
Kazutomo Ohashi
Akira Ohshima
Tetsunori Ozaki
Moemi Saito
Masahiro Sassaki
Eiji Shimizu
Masayuki Takahashi
Takashi Wada
Hiroshi Yamato
Chiharu Yoshii

Junichi Hasegawa
Yoji Hirayama
Mami Iida
Masayuki Kaji
Mikio Kawamata
Satoshi Kitamura
Yumiko Mochizuki
Hiroyuki Nagase
Yuri Nakata
Takashi Ohida
Koki Okamoto
Hironori Sagara
Reiko Saito
Masataka Sata
Masaki Shinjo
Yuji Takahashi
Hiroshi Yamashiro
Takeshi Yanase
Itsuro Yoshimi

International Advisors
Ted ChenMark Levin
Ill Soon Kim
Hong Gwan Seo
Jiefu Huang
Guihua Xu
Judith Mckay
Lisa Lau Man-man
W Y (Vienna) Lai
Sea-Wain Yau
Prakit Vethesatogki
Bungon Ritthiphakdee
Daniel Tan
Edgardo Ulysses Dorotheo
Soewarta Kosen
Yayi Suryo Prabandari
Mary Assunta
Harley Stanton
Ron Borland
Administrative committee (secretariat):
Committee Chairperson:
Kyoichi Miyazaki
Committee Members:
Yuji Ichikawa
Hikaru Iwase
Hiroyuki Kimura
Yumiko Mochizuki
Toru Mori

Honarary Executive Secretary of APACT
University of Hawaii at Manoa
Korean Association of Smoking and HealthDirector of National Cancer Control Institute, National Cancer Center, Korea
Chinese Association on Tobacco Control
Chinese Association on Tobacco Control
Asian Consultancy on Tobacco Control
Chairman of Hong Kong Council on Smorking and HealthHong Kong Council on Smoking and Health
Secretary-General of the John Tung Foundation
The Action on Smoking and Health Foundation
Secretary-General of the Campaign against Tobacco Consumption of Thailand
Tobacco-Free Philippines Foundation
Southeast Asia Initiative on Tobacco Tax (SITT)
National Institute of Health Research & Development
Universitas Gadjah Mada
Southeast Asia Tobacco Control Alliance (SEATCA)
President of the 9th APACT Conference
Cancer Council Victoria, Australia(Secretary-General)(secretariat)(in charge of financial affairs)(Japan Walking Association)(National Cancer Center)(Planning committee chairperson)

7

Reiko Saito
Manabu Sakuta
Tomoko Tsuji
Takeo Uchida
Takeko Yamashita
Takafumi Hirama
Katsuhide Ohashi

Event Committee:

PR Committee:

APACT Youth

Akira Hase
Hiroyasu Muramatsu
Masaaki Yamaoka
Hiroshi Nogami
Fumisato Watanabe
Sayaka Horiuchi
Kazumi Kubota
Naomi Sonoda(Japan Medical-Dental Association for Tobacco Control)(Vice-President)(secretariat)(Director of the Uchida Hospital)(in charge of public relations)(Director of the Hirama Hospital)(Director of the Ohashi Gastrointestinal Proctological
Surgical Clinic)(Director of the Hase Clinic of Internal Medicine)(Director of the Chuoh Naika Clinic)(Director of the Sumoto City Emergency Clinic)(Smoke-Free Environment Campaign for Kids in Japan)(Director of the Tobacco Problems Information Center)
Motoko Kametani
Takehiro Kawase
Masumi Okamoto
Haruka Sakamoto
Yoko Yanagawa

Kazuko Okada
Yoshihito Ohno
Hisashi Akiyama

Kiyoshi Nakamura
Fumiko Saito
Kunihiko Isobe

Chiba Prefecture (past and current)

Akira TsujimotoSupporters
Ministry of Health, Labour and Welfare
Japan Dental Association
Japanese Nursing Association
Chiba Prefecture
Chiba-ken Dental Association
Chiba Nursing Association
Chiba City Pharmaceutical Association
Embassy of Mexico in Japan

Japan Medical Association
Japan Pharmaceutical Association
National Governors' Association
Chiba Medical Association
Chiba Pharmaceutical Association
Chiba City
Embassy of India in Japan

Secretariat
APACT Japan secretariat
The Japan Society for Tobacco Control
30-5-201 Ichigaya-yakuoji-machi, Shinjuku-ku, Tokyo 162-0063, Japan
Phone number: 090-8442-0966
Fax number: 03-5360-6736
E-mail address: desk@apact.jp
URL: http://www.apact.jp/
Secretariat of the 10th APACT Conference (APACT 2013)
c/o ICS Convention Design lnc.
Chiyoda Bldg., 1-5-18 Sarugakucho, Chiyoda-ku, Tokyo 101-8449, Japan
Phone number: 03-3219-3541
Fax number: 03-3219-3577
E-mail address: apact2013@ics-inc.co.jp

8

Acknowledgement
We would like to thank the following organizations and companies.

The Tokyo Club（一般社団法人 東京倶楽部）

The John Tung Foundation
Japan Association Against Tobacco（全国禁煙推進協議会）
Chiba Convention Bureau and International Center
Chiba Prefecture

Luncheon Seminar Sponsor

Novartis Pharma K.K.

Pfizer Japan Inc.

Global Smoke-free Worksite Challenge(As of July 31, 2013)9

General Information and Social Program
Conference Date and Venue
Date:

August 18 (Sunday) -21 (Wednesday), 2013

Venue: International Conference Hall, Makuhari Messe in Chiba, Japan

Official Language
The official language is English.

Simultaneous Interpretations
Simultaneous interpretations (English to Japanese) will be available for Opening Lectures, all Plenary and Symposium
sessions.
Japanese participants who need to have a simultaneous Interpretation receiver, please come to the Receiver Desk
located in the foyer on the 2nd floor with a ticket. The receiver must be returned in the end of every day.

Registration
Registration Desk:
The registration desk is located in the Entrance Hall (1F) and will be open during following hours:
Open Hours:

August 18 (Sunday)

15:00 – 20:00

August 19 (Monday)

8:00 – 17:00

August 20 (Tuesday)

8:30 – 17:00

August 21 (Wednesday)

8:30 – 11:00

Registration fee includes:
Attendance to all scientific session, Exhibition, Opening Ceremony, Welcome Party, Lunch for two days (August 19
and 20), Coffee Breaks, Congress Bag, Program & Abstract Book and Pocket Program Book.

Name Badges
All registered participants are requested to wear name badges in order to join Scientific Session and Social Programs.
Please wear your name badges at all times during the conference period.

10Message Board
Any program changes or urgent announcement from the Secretariat and person-to-person messages will be postedon the Message Board located in the lobby on the 2nd floor.
Please check the board occasionally.

Internet AccessFree Wi-Fi access is available in the lobby area in International Conference Hall.
SSID:

MESSE

Password:

none

Secretariat Office
The Secretariat Office is Room 203 and opened during the following hours. For information concerning the programand miscellaneous, please inquire at the Secretariat Office.
Open Hours:

August 18 (Sunday)

15:00 – 20:00

August 19 (Monday)

8:00 – 17:00

August 20 (Tuesday)

8:30 – 17:00

August 21 (Wednesday)

8:30 – 13:00

Lunch
Boxed lunch will be served in the lobby on the 2nd floor on Mon., Aug. 19 and Tue., Aug. 20. Please line up in frontof the lunch served area with a lunch ticket.
Luncheon seminars will be held in Room 201, 301 and 303 on Mon. Aug. 19 and Room 201, 301 and 302 (Satellite
room of 301). The number of seat is limited and please be seated on a first-come-first-served. Those who wish toattend the seminar, please line up in front of the seminar room after getting a lunch box.
Participants will be free to eat lunch in Refreshment Space, located in the Convention Hall.

Welcome Party
Date:

August 18 (Sunday)Time:

18:00 – 20:00

Venue: Convention Hall B, 2nd floor of International Conference Hall, Makuhari Messe
Fee:Free of charge (included in Registration Fee) *Please attend after Registration

Photos
APACT Japan has updated photo page on APACT2013 webpage.
Please check photos from "Photo" menu icon on the page;
http://www.apact.jp/

11Meetings, Pre and Related Conference
Meetings

APACT Executive Committee Meeting
Date & Time: August 18 (Sunday), 14:00-15:30
Venue: Room 202
JSTC Board Meeting
Date & Time: August 18 (Sunday), 16:00-17:30
Venue: Room 202

Pre-Conference

Japan Society for Tobacco Control 9th Seminar of the Tobacco Cessation Therapy(禁煙学会 第9回禁煙治療セミナー)
Date & Time: August 18 (Sunday), 13:00-15:30
Venue: Room 201*Japanese Only
Japan Society for Tobacco Control 14th Board Examination of Tobacco Control Medicine(禁煙学会 第14回認定試験)
Date & Time: August 18 (Sunday), 13:30-15:30
Venue: Room 301*Japanese Only
Youth Conference
United for Tobacco Free World - What should WE do? Date & Time: August 18 (Sunday), 9:00 - 17:30
Venue: Room 302*Simultaneous interpretations (English to Japanese) will be available
WHO Workshop: Making your city Smoke-free
Date & Time: August 18 (Sunday), 9:00-16:00
Venue: Room 303*Simultaneous interpretations will not be available

Related Conference

Action planning and Training of National TB Programme (NTP) Managers on Integrating Brief Tobacco
Interventionsinto TB treatment Programme in Primary Care
Date: August 18 (Sunday) - 20 (Tuesday)
Venue: Room 205*Invited Only

A Lecture Open to Public（市民公開講座）
Date & Time: August 21(Wednesday), 14:30-16:00
Venue: International Conference Room*Japanese Only

12

Instruction for Oral Speakers and Session Chairpersons
1. Session Schedule & Venue
All oral sessions will be held at International Conference Room, Room 201, 301 or 302 of the International
Conference Hall, Makuhari Messe.
Please confirm your presentation date/time and room with the detailed program uploaded on the website;
http://www.apact.jp/program.html

2. Check-in at the Speakers’ Desk and Uploading Presentation Data
In order to ensure that the program runs smoothly, all speakers are requested to check-in at the Speakers’
Desk no later than 1 hour before your session start.
The Secretariat will provide a PC in a conference room. All speakers are requested to bring their own PC or
the data on a USB memory stick for presentation. In case you must use Macintosh or special software except
PowerPoint 2003, 2007, 2010 for presentation, please inform the staff at Speakers’ Desk.
The Speakers’ Desk will be located in front of International conference room, 2nd floor of International
conference Hall in Makuhari Messe, will be open during the following hours:
August 18 (Sunday)
15:00-18:30
August 19 (Monday)
8:00-16:00
August 20 (Tuesday)
8:00-16:00
August 21 (Wednesday)
8:30-10:30* All presentation files will be saved and up on APACT2013 website after the conference.
You are requested to appear in the room 10 minutes prior to the session start. Please be seated on the Next
Speakers’ Seats which are located in the front row in front of a podium.

3. Chairpersons’ Seat & Speakers’ Seat
You are requested to appear in the designated room 15 minutes prior to the session start.
The Next Chairpersons’ Seats are located in the front row in front of the Chairpersons’ Seat.
Please meet your counterpart who will be co-chairing the session and confirm the schedule of the session.
Speakers are due to appear in the room 10 minutes in advance to the session start. Please report theattendance to the room staff.
If your counterpart does not appear…Please run the session by yourself.
If presenter(s) do not appear…Please treat the presentation as withdrawal, and take a break with the time
allocated to the cancelled paper. Do not shift other presentations forward.

13

4. Time Allocation
Presentation

Discussion

Total

Plenary 1, 3, 4

25min.

*see Caution

25min.

Symposium

12min.

3min.

15min.

*Plenary 2 … PL2-01 Presentation 25min. / PL2-02, 03, 04 Presentation 12min.

Caution

Caution for Plenary Session is left a decision up to the Session Chair.

Symposium Session
After a lapse of

Number of bells

Meaning

11 min.

1 bellOne minute left

12 min.

2 bells

End of presentation

15 min.

3 bells

End of discussion

Time keeping is crucial to ensure the smooth operation of the entire program.
Please kindly make sure that each presentation is done within the allocated time and chairpersons encourage active
discussion during discussion time.
When chairpersons close the session, please announce about the coffee break.

5. Equipment for Presentation
Conference rooms are provided with Windows laptop computer with LCD (Liquid Crystal Display) projector onwhich Microsoft PowerPoint is installed (OS: Windows7, English version; Software: Microsoft PowerPoint 2003,
2007, 2010). Speakers who bring your presentation data by a USB memory stick are required to use Windowsformat. All speakers are requested to visit the Speakers’ Desk even if you use your own PC for presentation.
The name of the file should be labeled with session number and your name as follows:e.g. S01_TadaoShimao.ppt* Presenter View function of PowerPoint will not be available.
* Sound system will not be available even if you bring your own PC.
* Macintosh is not provided. If you must use one, please bring your own PC.
* Please note that the projectors are connected to computers via a D-sub 15-pin plug. If your PC does not use
this type of plug, please bring the necessary adaptor with you.
D-Sub 15pins* During the presentation, please be sure that your PC is connected to a power source to avoid battery
accidents. Electric currency is uniformly 100 volts AC throughout Japan, but with two different cycles: 50Hz
in eastern Japan including Chiba, and 60Hz in western Japan. Electric outlet sockets accept a two-leg plug.
A type (Two-leg plug)* Please make sure that the power-saving features are deactivated such as cancellation of sleep mode,
screen saver, password, etc.

14

Instruction for Poster Presentation

1. Poster Boards
The Secretariat will supply you with a poster board.
Size: Width 99cm x Height 210cm
Recommended usable area: Width 80cm x Height 160cm
Poster Number: A5 size (Provided by the Secretariat)
Posters should be displayed on the boards using pushpinsthat will be available at the Poster Session room.
No other adhesive method is permitted on the boards.

2. Room and Schedule
All posters will be displayed at the
Poster Session Room (Convention Hall).
You are responsible for setting up and removing your poster.

Width 99cm
Poster No.
A5 Size

Height 210cm

Recommended
usable area:
Width 80cm
xHeight 160cm

The Secretariat will not be responsible forthe loss of the poster after removal time.
Poster Set-Up: in the morning on August 19, 2013
Poster Removal: from 11:30 to 12:30 on the last day, August 21.
*There is no core-time to poster presentations.

15

Floor Plan
1st Floor

EV

WC

105

101

102

104

103

■Registration
Desk

LoungeEV

WC

Entrance

2nd Floor

■205
■203

■204

Secretariat

Press Room

Aug. 18-20
・Action planning and Training of National TB Programme(NTP) Managers on Integrating Brief Tobacco
Interventionsinto TB treatment Programme in Primary CareEV

203 204 205■202
Aug. 18 ･APACT Executive Committee Mtg./
JSTC Board Mtg.
Aug. 19-20 Speakers Room (Pre-Meeting Room)

202

■201

EV

A

WC

Aug. 18 ・Japan Society for Tobacco Control
9th Seminar of the Tobacco
Cessation Therapy

Aug. 19 ・Luncheon 1 / Symposium 2, 6
Aug. 20 ・Luncheon 3 / Symposium 10, 14
Aug. 21 ・Symposium 17

201

Convention
Hall

Exhibition Area

B

■Receiver Desk

International
Conference
Room

Take Free Corner/Message Board

EV

WC

WC

■Convention Hall B
Aug. 18
・Welcome Party■International Conference Room
Aug. 19
Aug. 20
Aug. 2116

・Opening/ PL-1/
Symposium 1, 5
・PL-2, PL-3/Symposium 9, 13
・PL-4/Symposium 16 / Closing
Public Lecture■Convention Hall A+B
Speakers DeskCoﬀee Break/Box Lunch CornerAug. 19-21
・Poster Session/
Refreshment Space3rd Floor■302
Aug. 18
Aug. 19
Aug. 20
Aug. 21■301
Aug. 18 ・Japan Society for Tobacco Control
14th Board Examination of
Tobacco Control Medicine
Aug. 19 ・Luncheon 2 / Symposium 3, 7
Aug. 20 ・Luncheon 4 / Symposium 11,15
Aug. 21 ・Symposium 18

・Youth Conference・Symposium 4, 8
・Luncheon 4 Satellite / Symposium 12・Symposium 19

WC

302
301
303

■303
Aug. 18
Aug. 19304

・WHO Workshop : Making YourCity Smoke-Free・Luncheon Seminar by WHO WPRO

EV

17

Poster Layout
Convention Hall
PL1-01~05

PL2-01~03

PL3-07~12

PL3-01~06

PL3-13~17

PL4-01~06

PL4-13~18

PL4-07~12

S1-01~06

S1-07~12

S4-01~04 S3-04~05

S3-01~03 S1-13~14

S4-05~10
S5-09~13
S5-14~16 S6-01

S4-11~12 S5-01~03
S5-04~08
S7-01~06

S8-06~10

S8-01~05

S8-11~15

S9-01~05

S9-11~15

S9-06~10

S9-16~20

S9-21~25

S9-32~36

S9-26~31

S9-37~41

S10-01~06

S10-13~17

S10-07~12

S10-18~22

S10-23~28

S10-35~39

S10-29~34

S10-40~44

S10-45~49

S10-57~61

S10-51~56

S10-62~66

S10-67~72

S11-01~04
S12-01~02 S13-01~03
S15-01~05
S15-06~10
S18-01~02 S17-07~09
Y1-01~05

APACT
Youth

PL2-04~05

O-01~10

S10-73~78
S14-01~06
S14-07~09
S16-01~05
S17-01~06
Y1-06~10
O-11~13

1
2
3
4
5
6
7
8

18

9

Exhibitors⑯ JAPAN PEDIATRIC
SOCIETY⑰ APACT2013
Planning Committee⑭ Kin-en Kobo
（Anti-tobacco
Goods Production）⑫ WALK AGAINST⑯ JAPAN PEDIATRIC⑪ Tobacco
SOCIETYFree
EHIME⑬ Tobacco Free Sagami⑰ APACT2013
TOBACCOPlanning Committee⑮ Ministry of Health,Labour and Welfare⑩Ministry
TobaccoProblems⑮
of Health,Labourand Welfare
Information
Center⑧ Japan Medical-Dental Association
for Tobacco Control⑭ Kin-en Kobo
（Anti-tobacco
Goods Production）⑫ WALK AGAINSTTOBACCO⑨ Japan Anti-Tuberculosis Association⑬ Tobacco Free Sagami⑦ The 8th Annual Meetingof the Japan⑩ Tobacco
Problems
Societyfor Tobacco
Control⑪ TobaccoFree EHIME⑧ Japan Medical-Dental Association
for Tobacco Controlー⑨ Japan Anti-Tuberculosis Association

Information Center⑱ MeetingJohn Tung⑦ The 8th Annual
Foundationof the Japan
Society for Tobacco Control⑱ John Tung
⑥ Takeda Pharmaceutical ⑤ Southeast Asia ④ TaishoPharmaceuticalCo., Ltd./Foundation
Company Limited.
Tobacco Control
glaxosmithkline.K.K.
Alliance(SEATCA）

ー⑥ Takeda Pharmaceutical ⑤ Southeast Asia ④ TaishoPharmaceutical Co., Ltd./
Company Limited. ③ Novartis
Tobacco Control
Pharma K.K. glaxosmithkline.K.K.
Alliance(SEATCA）③ Novartis Pharma K.K.

① HARADA CORPORATION① HARADA CORPORATION

1② UNEX Corporation② UNEX Corporation

HARADA CORPORATIONUNEX Corporetion
2 CORPORATION
HARADA10

Tobacco Problems Information CenterFree EHIME
1110 Tobacco
TobaccoProblems Information Center

3

Novartis Pharma K.K.

12

WALK AGAINST TOBACCO

4

TaishoPharmaceutical Co., Ltd./glaxosmithkline.K.K.

13

Tobacco Free Sagami

UNEX Corporetion11

Tobacco Free EHIMEWALKAGAINST TOBACCO
12 Kin-en
Kobo（Anti-tobacco Goods Production）

Novartis5 Pharma
K.K.
Southeast Asia Tobacco Control Alliance

14

TaishoPharmaceuticalCo., Ltd./glaxosmithkline.K.K.
Takeda Pharmaceutical
Company Limited.
6

TobaccoFree
Sagamiof Health,Labourand Welfare
1513 Ministry

The Tobacco
8th Annual Control
Meeting ofAlliance
the Japan Society for Tobacco Control
7 AsiaSoutheast

PEDIATRIC
SOCIETY
1614 JAPANKin-enKobo（Anti-tobacco
Goods Production）

Takeda Pharmaceutical Company Limited.

8

Japan Medical-Dental Association for Tobacco Control

17

9Japan Anti-Tuberculosis Association

18

APACT2013 Planning Committee

of Health, Labour and Welfare
15 JohnMinistry
Tung Foundation

16

JAPAN PEDIATRIC SOCIETY

Japan Medical-Dental Association for Tobacco Control

17

APACT2013 Planning Committee

Japan Anti-Tuberculosis Association

18

John Tung Foundation

The 8th Annual Meeting of the Japan Society for Tobacco Control

19

Makuhari Map
Access to MAKUHARI MESSE
Makuhari kaihin koen
APA Hotel & Resort〈Tokyo Bay Makuhari〉

Hall 8Messe Ohashi

Hall 7

Hall 6

Hall 5

Hall 4

Hall 3

Hall 2

Hall 1

Makuhari Messe
MAKUHARI
MESSE
Int'l Exhibition Hall 1〜8
East Entrance(2F)Hotel New Otani
Makuhari

Int'lConference
Hall

Front
Entrance

West Entrance(2F)CentralEntrance（２F）

Makuhari
Event Hall

Outdoor
Exhibition Space

Central Traﬃc
Terminal

Messe

IN

International Messe-Odori St.
Toyosuna

Kokusai-odori St.

Hotel
Hotel
FrancsThe Manhattan
Hotel Green
Tower MakuhariWorld Business
Garden WestHall 9Messe Mall

Tokyo
Gas

Hall 10
Messe Mall
Parking Lot

World Business
Garden East

Plena
Makuhari

MitsuiOutlet Park
Makuhari

Makuhari
Messe
Parking
Area

1F
2F
One WayIN

Hall 11

Elevator（underground）

Int'l Exhibition Hall
9〜11
RotaryTo Sogaation

To Tokyo St

e

JR Keiyo Lin

KAIHIM MAKUHARI
StationHotel
Springs
Makuhariaune
MakuhariBus
Rotarysu:kKaihin makuhari

Messe
Amuse Mall

KITZ

AEON
Makuhari Techno
Garden（MTG）

Drivers License
CenterFujitsuNTT

2011.03 3,000

Access to MAKUHARI MESSE
Hanamigawa River〈By Car〉

Hamadagawa River

Chiba Rinkai Line
（City Road）

Makuhari Beach
Makuhari Beach
QVC
Marine ﬁeld

Hotel
LEGEND

Makuhari Messe

P1
up a bridge on the left,
Before crossing “TOYOSUNA”

P2

To SogaKemigawahama

JR Keiyo Line

JR Kaihim makuhari
LicenseCenterTo Tokyo357
To Tokyo

357

Wangan-Narashino I.C.
Higashi-Kanto
Expressway

Wangan-Chiba I.C.

HAMADAMAKUHARI
1-CHOMETo Narita

Kemigawa
Shinkemigawa

To Chiba

Keisei Makuhari

Makuhari

Keisei Line
JR Sobu Line

Makuhari I.C.

o
eiy

d

oa

ll R

To

K

〈By Train〉

Bus Rotary

Makuharihongo● Approx. 40 minutes from downtown
Tokyo or Tokyo International Airport(Haneda) to Makuhari Messe via the
Higashi Kanto Expressway (exit at
the Wangan Narashino Interchange)or the Keiyo Toll Road (exit at the
Makuhari Interchange). 5 minutes to
Makuhari Messe from either exit.
● Approx. 30 minutes from Narita
International Airport via the Higashi
Kanto Expressway. 5 minutes to
Makuhari Messe from the WanganChiba Interchange exit.
＊ Limousine Bus services from bothTokyo International Airport (Haneda)
and Narita International Airport areavailable.
＊ Messe Parking Area P 1 accommodates approx. 5,500 vehicles and120 buses. Messe Mall Parking
Area P 2 (underground) accommodates approx. 280 vehicles.

To Tokyo● Approx. 30 minutes from Tokyo
Station or 12 minutes from Soga
Station to Kaihim Makuhari Stationon the JR Keiyo Line. 5 minutes
walk to Makuhari Messe.
● Approx. 40 minutes from Akihabara
Station to Makuhari Hongo Stationon the JR Sobu Line. 15 minutes bybus to Makuhari Messe.

Nakase Mihama-ku, Chiba-city, 261-0023, Japan TEL.043-296-0001 9:00〜17:30
Makuhari Messe, Inc. 2-1
URL http://www.m-messe.co.jp/

20Program at a Glance
August 18 [Sunday], 2013
Time
Floor

Convention Hall
2F

Room 201
2F

Room 301
3F

Room 302
3F

Registration 15:00 - 20:00
9:00

9:00 - 17:30

Youth Conference（*Pre-registration is
Required）
10:00

Room 205
2F

Room 303
3F

8:30 - 17:15
Action planning and9:00 - 16:00
Training of National
TB Programme
WHO Workshop;（NTP）Managers on
Making Your City
Integrating Brief Tobacco
Smoke-FreeInterventions into TB（*Pre-registration istreatment Programme in
Required）
Primary Care（*Invited Only）

11:00

12:00

13:00

13:00 - 15:30
禁煙学会
第9回禁煙治療セミナー
Japan Society for Tobacco
Control
9th Seminar of the Tobacco
Cessation Therapy（*Japanese Only）

14:00

13:30 - 15:30
禁煙学会
第14回認定試験
Japan Society for Tobacco
Control
14th Board Examination of
Tobacco Control Medicine（*Japanese Only）

15:00

16:00

17:00

18:00

19:00

18:00 - 20:00

Welcome Party

20:00

21

Time
Floor

International
Conference Room
2F

August 19 [Monday], 2013
Room 201
2F

Room 301
3F

Room 302
3F

Room 303
3F

Convention Hall
2F

Foyer
2F

Room 205
2F

Registration 8:00 - 17:00

9:00 9:00 - 9:30
Opening Ceremony

9:00 - 17:00

Poster

9:30-9:40 Break
9:40 - 10:10

Opening Lecture 1
10:00 David YEN Memorial Lecture

Evolution and Perspectiveof APACT
Chair: Sea-Wain YAU（JTF, Taipei）
10:10 - 10:35

Opening Lecture 2

The Endgame
Chair: Kyoichi MIYAZAKI（Japan）
10:35 - 11:00
Coffee Break

11:00 11:00 - 12:15
Plenary Lecture 1

Where are wewith FCTC?（1）Achievement andchallenges
Chair: Akira OHSHIMA（Japan）
12:00
Douglas BETTCHER（WHO）
12:15 - 12:30 Break
12:30-13:30

12:30-13:30

12:30 - 14:00

Luncheon Seminar 1 Luncheon Seminar 2
Sponsored by Pﬁzer
Japan Inc.

13:00
13:30 - 15:00

Symposium 1

13:30 - 15:00

Symposium 2

Protection from
Illness-speciﬁc
exposure toissues. 1.
14:00 tobaccosmoke. 1.
Smoking andLegislative actions
COPD
by the local
autonomy
Chair: Hiroshi KAWANE（Japan）
Chair: Shigefumi
MATSUZAWA（Japan） Tara BAM（IUATLD）
Christine WONG
（Hong Kong）

15:00

Symposium 5

Protection fromexposure to
16:00 tobacco smoke. 2.
Toward smoke-freeworkplace andpublic space
Chair: Masayuki
TAKAHASHI（Japan）
Domilyn VILLARREIZ（Philippines）

22

Sponsored by
APACT2013

13:30 - 15:00

Symposium 3

Sponsored by
WHO WPRO

13:30 - 15:00

Symposium 4

Illness speciﬁc
Illness speciﬁc
issues. 2.
issues. 3.
Smoking and oral Smoking and HeartdiseaseshealthChair: Tetsunori OZAKI
Chair: Hisayoshi（Japan）
FUJIWARA（Japan）
Takashi HANIOKA
Tsu-Shing WANG（Taipei）（Japan）

15:00-15:30 Coffee Break
15:30 - 17:00

17:00

Luncheon Seminar

15:30 - 17:00

Symposium 6

Illness speciﬁc
issues. 4.
Smoking andTuberculosis
Chair: Toru MORI
（Japan）
Chi Chiu LEUNG（Hong Kong）

15:30 - 17:00

Symposium 7

15:30 - 17:00

Symposium 8

Women and Tobacco Roles of nurses
Useand other healthprofessionals in the
Chair: Reiko SAITO（Japan）
tobacco epidemic
Bungon RITTHIPHAKDEE Chair: Kenji AMAGAI（Thailand）（Japan）
Sophia CHAN
（Hong Kong）

8:30 - 17:15
Action9:00 - 17:00 planning andTraining of
Exhibition National TB
Programme（NTP）
Managers on
Integrating
Brief Tobacco
Interventions
into TB
treatment
Programme inPrimary Care（*Invited
Only）

Time
Floor

International
Conference Room
2F

August 20 [Tuesday], 2013
Room 201
2F

Room 301
3F

Room 302
3F

Convention Hall
2F

Foyer
2F

Room 205
2F

Registration 8:30 - 17:00

9:00 - 17:00

9:00 9:00 - 10:15

Plenary Lecture 2

PosterNCD Commitment.
Fighting together with other
health problems
Chair: Tadao SHIMAO（Japan）
Prakit VETHESATOGKIT（Thailand）
10:00
10:15 - 10:45
Coffee Break

8:30 - 15:30
Action planning
and Training
9:00 - 17:00
of National TB
Exhibition
Programme（NTP）
Managers on
Integrating
Brief Tobacco
Interventions into
TB treatment
Programme inPrimary Care（*Invited Only）

10:45 - 12:15

Plenary Lecture 3

11:00

MOF Summit
Price and taxations.
Countries’ experiences
Chair: Shigefumi
MATSUZAWA（Japan）
Ayda Aysun YUREKLI
（WHO）

12:00
12:15 - 12:30 Break
12:30 - 13:30

12:30 - 13:30

12:30 - 13:30

Luncheon Seminar 3

Luncheon Seminar 4

Luncheon Seminar 4*Satellite

Sponsored by Global Smoke
Free

13:00

13:30 - 15:00

Symposium 9

13:30 - 15:00

Sponsored by Novartis

13:30 - 15:00

Symposium 10

Symposium 11

Treatment of tobacco
Price and taxations.
Education,
dependence
communication, training General discussions
14:00 Chair: Shuichi OTAKE（Japan） and public awareness
Chair: Hiroshi NOGAMI
Marewa GLOVER（Japan）
Chair: Yoneatsu OSAKI（New Zealand）
Hana ROSS（USA）（Japan）
Zee Yoong KANG（Singapore）

Sponsored by Novartis

13:30 - 15:00

Symposium 12

Other forms of tobacco/ Substances simulating
tobaccoChair: Gauri DHUMAL（India）
Kazunori NAKAKUKI（Japan）

15:00
15:00-15:30 Coffee Break
15:30 - 17:00

Symposium 13

15:30 - 17:00

Symposium 14

15:30 - 17:00

Symposium 15

Litigation/Regulation
Tobacco industry
Packaging and labelingof the contents ofand Corporate Socialof tobacco products,
16:00 tobacco products andResponsibility
Countries’ experiencesof tobacco product
Chair: Hiroshi KAWANE
Chair: Mary Assunta KOLANDAI
disclosure（Japan）（Australia）
Geoffrey
FONG（Canada）
EdgardoUlysses
DOROTHEO
Chair: Koki OKAMOTO（Japan）（Philippine）
Ron BORLAND（Australia）

17:00

23

Time
Floor

International
Conference Room
2F

August 21 [Wednesday], 2013
Room 201
2F

Room 301
3F

Room 302
3F

Convention Hall
2F

Foyer
2F

9:00 - 11:30

9:00 - 11:30

PosterExhibition

Registration 8:30 - 10:00

9:00 9:00 - 10:30

Plenary Lecture 4

10:00

Where are we with FCTC ?（2）Obstacles and ways to overcome
themChair: Makiko YAMAMOTO（Japan）
Mark LEVIN（USA）

10:30 - 11:00
Coffee Break
11:00 11:00 - 12:30

Symposium 16

11:00 - 12:30

Symposium 17

Issues of trade and tobacco Protection of public healthmarket opening andpolicies from commercial
APACT: Ending the game and other vested interestsof the tobacco industry /Chair: Judith MACKAY
Liability（Hong Kong）
Prakit VETHESATOGKIT（Thailand） Chair: Ritsu KATAYAMA（Japan）
Mark LEVIN（USA）
12:00
Pei-kan YANG（Taipei）

12:30 - 13:00

Closing Ceremony
13:00

14:00

14:30 - 16:00

A lecture open to the public
15:00

16:00

17:00

24

（*Japanese Only
*Pre-Registration is required）

11:00 - 12:30

Symposium 18

Inequities in tobacco use
and tobacco control andits implication for tobacco
control
Chair: Yayi Suryo PRABANDARI（Indonesia）
Geoffery FONG（Canada）

11:00 - 12:30

Symposium 19

APACT Youth for the future
demandChair: Nicole SUTTON（USA）
Haruka SAKAMOTO（Japan）

Full Program
9:00 - 17:30 Youth Conference		 United for Tobacco Free World -What shoud WE do?Key Note Lecture 1: "Youth and tobacco advertising, promotion and sponsorship"
Dr. Douglas W. BETTCHER
Prevention of Non-communicable Diseases (PND), World Health Organization

Room: 302

Key Note Lecture 2: "What is done and what is to be done"
Dr. Yumiko MOCHIZUKI
Center for Cancer Control

August 19

Lunch Session "A popular Buddhist temple as a starting place for tobacco free initiative"
Akinori KURUMA, M.D., Ph.D.
Priest-in-chief Koganji Temple Tokyo Japan
Councilor of Japan Society for Tobacco Control (JSTC)
Specialist physician for cardiology and smoking cessation

August 18

August 18 (Sunday)

Poster Presentation
Share good practices related to tobacco control among countries.
World Café
Divided into small groups and discuss challenges and countermeasures for tobacco epidemics.
Keynote Remarks "Youth Activism: Empowering the Next Generation of Tobacco Control Partners!"
Ms. Nicole M. SUTTON
REAL: Hawaii Youth Movement Exposing the Tobacco Industry, University of Hawaii - Manoa Closing

14:55 - 15:10
15:10 - 15:45

15:45 - 16:00

8:30 - 17:15	Action planning and Training of National TB Programme (NTP) Managers on Integrating Brief
Tobacco Interventions into TB treatment Programme in Primary Care
Room: 205
18:00 - 20:00

Welcome Party

Room: Convention Hall

25

August 21

12:00 - 13:00
13:00 - 14:55

WHO Workshop: Making Your City Smoke-Free
Room: 303
Part I: Introduction, Background, and Twelve Steps
Welcome, workshop overview and participants self-introduction
Presentation: Second-hand smoke and healthPresentation: Overview of the current situation in WPRO region
Presentation: Tobacco industry tactics and the WHO FCTC Article 5.3
Presentation: Smoke-free Davao City (Philippines)
Questions and answers
Break
quiz1
Presentation: Twelve steps towards a smoke-free city
Questions and answers
Introduction to group exercises
Group announcement 2 (each group to choose two out of three options for the afternoon exercise)
LunchPart II: Assessment and Strategic PlanningGroup exercise: Spidergram assessment / Barrier analysis / Stakeholder mapping
Group reporting (at least one per option)
BreakPart III: Policy
Presentation: Legislation – model ordinance
Questions and answers
Closing and evaluation

August 20

9:00 - 16:00
9:00 - 12:00

August 19 (Monday)

August 18

9:00 - 9:30

Opening Ceremony

Room: International Conference Room

9:30 - 9:40

Break

9:40 - 10:10

Opening Lecture 1
Room: International Conference Room
Dr. David Yen Memorial Lecture: Evolution and Perspective of APACT
Chair: Sea-Wain YAU (JTF, Taipei)

OL1-01

10:10 - 10:35

Kyoichi MIYAZAKI
MPH, Secretary General of APACT 2013

August 19

Opening Lecture 2
The Endgame

Room: International Conference Room

Chair: Kyoichi MIYAZAKI (Japan)
OL2-01

Judith MACKAYWorld Lung Foundation, Bill and Melinda Gates Foundation

10:35 - 11:00

Break

11:00 - 12:15

Plenary Lecture 1
Room: International Conference Room
Where are we with FCTC ? (1) Achievement and challenges
Chairs: Akira OHSHIMA (Japan)
Douglas BETTCHER (WHO)August 20

PL1-01
KeynoteProgress in Tobacco Control: Evidence from Countries at the Forefront of Tobacco Control
Ron BORLANDThe Cancer Council Victoria

PL1-02

Where Are We with FCTC? Achievement and Challenges in Hong Kong
Lisa LAU
Hong Kong Council on Smoking and Health

PL1-03

Where are we with the FCTC? Achievements and challenges
Prakit VATHESATOGKIT
Action on Smoking and Health Foundation Thailand

August 21

12:15 - 12:30

Break

13:30 - 15:00

Symposium 1
Room: International Conference Room
Protection from exposure to tobacco smoke. 1. Legislative actions by the local autonomy
Chairs: Shigefumi MATSUZAWA (Japan)
Christine WONG (Hong Kong)

S1-01
KeynoteS1-02

26

Enforcement of Smoking Ban: Hong Kong Experience
Christine WONG
Hong Kong Special Administrative Region
Legislative Actions by the Local Autonomy
Yu-Jin PAEK
Hallym University Medical College

S1-04

Second-hand Smoke Exposure of Children in Cars in New Zealand: Repeated National Survey
Data
Benjamin HEALEY1, Richard EDWARDS1, Nick WILSON1, George THOMSON1, Janet HOEK1,Steve TAYLOR2
University of Otago1, AUT University2

S1-05

Awareness of Advertisement and Campaign of Smoke-Free Melaka Policy among People in
Melaka: Findings from Evaluation of Smoke- Free Melaka Intercept StudyYahya BABA1, Maizurah OMAR2, Rahmat AWANG1,2, Noraryana HASSAN3, Nur Hanani JASNI2,
Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH4, Pete DRIEZEN4, Mary THOMPSON4,
Geoffrey T. FONG4MySihat1,Clearing house for Tobacco Control2, Melaka State Health Departments3, University of Waterloo4

S1-06

The Changes in Smoking Related Behaviours, Second Hand Smoke and Smoking Cessation after
the Smoking Ban in Izmir, Turkey
Pakize A. TURAN1, Gul ERGOR2, Muzaffer O. TURAN3, Sinem DOGANAY2, Oğuz KILINC2
Afyon State Hospital1 , Dokuz Eylul University2, Bolvadin State Hospital3

15:00 - 15:30

Break

15:30 - 17:00	Symposium 5
Room: International Conference Room
Protection from exposure to tobacco smoke. 2. Toward smoke-free workplace and public space

August 19

To Persuade Local Government in the Establishment of Non-smoking Regulations
Masatoshi SEKIGUCHI
Smoke-Free Caravan Association

August 18

S1-03

Chairs: Masayuki TAKAHASHI (Japan)
Domilyn VILLARREIZ (Philippines)
Current Situation of Second-hand Smoke in Japan
Hiroshi YAMATO
University of Environmental Health
Korea’s Steps toward Smoke-free Workplace and Public Space
Eun Ji KIM
Korean Association on Smoking or Health, Ajou University School of Medicine

S5-03

Multiple Chemical Sensitivity due to Passive Smoking: a Unique Japanese Syndrome?
Michiyuki MATSUZAKI
Fukagawa City Hospital

S5-04

Smoking on the Margins: An Equity Analysis of Vancouver's Outdoor Smoke-free Policy in Parks
and on Beaches
Chizimuzo T. OKOLI1, Ann PEDERSON2, Wendy M. RICE2
University of Kentucky1, British Columbia Centre of Excellence for Women's Health2

S5-05

Smoke-free Tourism: Wave of the Future:
Domilyn VILLARREIZSoutheast Asia Tobacco Control Alliance, Framework Convention Alliance

S5-06

Tobacco Control in Hong Kong: a 30-year Experience
Lisa LAU, Vienna LAI
Hong Kong Council on Smoking and HealthAugust 21

S5-02

August 20

S5-01
Keynote27

12:30 - 13:30

August 18

Luncheon Seminar 1
Challenges of anti-smoking measures: Lessons learned from Turkey and Japan
Sponsored by Pfizer Japan Inc.

Room: 201

Chair: Satoshi KITAMURA
Director of Minami-tochigi Hospital, Japanese Respiratory Foundation
Speakers: Elif DAGLI
Health Institute Turkey National Coalition on Tobacco or Health
Issues Concerning Anti-Smoking Programs in Japan
Yoko KOMIYAMA
Former Minister of Health, Labour and Welfare
The Yoko Komiyama Policy Research Council
13:30 - 15:00

Symposium 2
Illness-specific issues. 1. Smoking and COPD

Room: 201

August 19

Chairs: Hiroshi KAWANE (Japan)
Tara BAM (IUATLD)
S2-01
KeynoteThe Effects of Weight Control Perception on Quitting and Cigarette Consumption: Findings fromthe ITC Project
Ce SHANG1, Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Mary THOMPSON2,
Mohammad SIAHPUSH4
University of Illinois at Chicago1, University of Waterloo2, Ontario Institute for Cancer Research3,
University of Nebraska Medical Center4

August 20
August 21

S2-02

Mortality Risks of COPD for Nonsmokers and Smokers from a Prospective Cohort Study of390,269 Subjects in Taiwan- Assessing Involvement beyond the Lungs
Chi-Pang WEN, Wei-Erh CHENG, Min-Kuang TSAI, Shiuan Be WU
National Health Research Institutes, China Medical University Hospital

S2-03

Early Detection and Treatment of COPD Can Be Made by Tobacco Cessation Clinic
Junji MORITA1,2, Kohichi KIMURA1, Katashi SATOH3, Risa YAMAGAMI1
Kimura Chest Clinic1, Matsubara Hospital2, Kagawa Prefectural Health Sciences3

S2-04

Relationship between Respiratory Diseases of Schoolchildren and Tobacco Smoke in Hong Kongand Sri Lanka
S. H. LEE, W. T. HUNG
The Hong Kong Polytechnic University

S2-05

Examination about the Usefulness of Hi-checker in Smoking Outpatients
Naoto WATANABE1,2, Keigo SASAKI2, Kazunori ARAI1, Sohei MAKINO1Tokyo Allergic and Respiratory Disease Institute1, Sasaki Hospital2

S2-06
Hajime KUROSAWA
Tohoku University
15:00 - 15:30

28

Break

15:30 - 17:00	Symposium 6
Illness specific issues. 4. Smoking and Tuberculosis

Room: 201

S6-01
KeynoteAugust 18

Chairs: Toru MORI (Japan)
Chi Chiu LEUNG (Hong Kong)
Tobacco Cessation Interventions for Tuberculosis Patients
Tara S BAM1, Md Akramul ISLAM2, RUBAEAH3, Rana J SINGH4, Lin YAN5International Union Against Tuberculosis and Lung Disease1, BRAC Health, Nutrition & Population
Program2, Bogor City Health Office3, The Union South-East Asia Office4, The Union China Office5
Smoking and Tuberculosis
Chi Chiu LEUNG
Tuberculosis and Chest Service

S6-03

Smoking Habit of Tuberculosis Patients in Japan
Toru MORI, Yuko YAMAUCHI
Research Institute of Tuberculosis

S6-04

Helping TB Patients Quit Smoking: The Potential Impact, WHO Recommendations and Country
Experience
Dongbo FU
World Health Organization

S6-05

The Association between Smoking and Sputum Smear-positive Pulmonary Tuberculosis in OsakaCity
Jun KOMUKAI1, Kenji MATSUMOTO1, Shinichi KODA1, Kazuhiko TERAKAWA2, Akira SHIMOUCHI3
Osaka City Public Health Office1, Osaka City Health Bureau2, Osaka City Nishinari Ward3

August 19

S6-02

Room: 301

13:30 - 15:00	Symposium 3
Illness specific issues. 2. Smoking and oral health

Room: 301

Chairs: Tetsunori OZAKI (Japan)
Takashi HANIOKA (Japan)
S3-01
KeynoteAugust 20

12:30 - 13:30	Luncheon Seminar 2
Maximizing the Efficacy of Nicotine Replacement Therapy
Sponsored by APACT2013 Organizing Committee
Speaker: Richard D. HURT
Nicotine Dependance Center Mayo Clinic

Smoking and Oral Health
Tetsunori OZAKI
Nihon University
Development of Oral Lesion Screening Clinic in Hospital Dental Department
Piyada PRASERTSOM1, Sutha JIENMANE-CHOTCHAI1, Siripen ARUNPRAPHAN2,
Woranut WEERAPRADIST3, Somjin CHINDAVIJAK4
Ministry of Public Health1, Thai Dentist against Tobacco Project2, Mahidol University3, National Cancer
Institute4

S3-03

Novel Curriculum of Smoking Cessation for Dental Students
Takashi HANIOKA
Fukuoka Dental College

S3-04

The Attitude Survey of Smoking Associated with Periodontal and Peri-implant Disease
Ken YUKAWA, Motohiro MUNAKATA, Noriko TACHIKAWA, Shohei KASUGAITokyo Medical and Dental University

August 21

S3-02

29

August 18

S3-05

Characteristic of Dental Care Received by Smokers in Japan
Miki OJIMA1, Takashi HANIOKA2
Osaka University1, Fukuoka Dental College2

S3-06

Physiological Metals in the Serum, Hair and Nails of Patients with Head and Neck Cancer
Anna M. WOZNIAK1, Maksymilian J. KULZA1, Monika A. SENCZUK-PRZYBYLOWSKA1,
Anita KUJAWA1, Wojciech GOLUSINSKI2, Krzysztof SZYFTER1,3, Wojciech PIEKOSZEWSKI4,
Witold SZYFTER1, Ewa K. FLOREK1
Poznan University1, Greater Poland Cancer Centre2, Institute of Human Genetics3, Poznan Jagiellonian
University4

15:00 - 15:30

Break

15:30 - 17:00

Symposium 7
Women and Tobacco Use

Room:301

August 19

Chairs: Reiko SAITO (Japan)
Bungon RITTHIPHAKDEE (Thailand)
S7-01
KeynoteAugust 20
August 21
30

Women and Tobacco Use in ASEAN: Challenges and Way Out
Bungon RITTHIPHAKDEESEATCA

S7-02

Prevention and Management of Tobacco Use and Exposure to Second-hand Smoke in Pregnancy.
A New WHO Publication
Carmen Audera LOPEZWorld Health Organization

S7-03

Assessing the Feasibility of Plain Packaging of Tobacco Products as a Tobacco Control Measure
in India
Monika ARORA1,2, Abha TEWARI2, Nathan GRILLS3, Juhi SONREXA3, Gaurang P. NAZAR2,
Rob MOODIE3, K Srinath REDDY1
Public Health Foundation of India1, Health Related Information Dissemination Amongst Youth2, Nossal
University of Melbourne3

S7-04

Women’s Network for Smoke-Free Thai Communities
Chanthana VITAVASIRI, S. AROONPRAPAN, R. TORPRADIT, B. PISANSARAKIT,
A. TARADOLRATANAKORN, Somsri PAUSAWASDI
Thai Health Professional Alliance Against Tobacco

S7-05

Awareness of Smoking and Second-hand Smoke among Japanese women
Reiko SAITO
Jumonji University

S7-06

Changes in Gender Differences on Smoking Behavior and Perception in Thailand: A Longitudinal
Descriptive Analysis from ITC-Thailand Waves 1 - 5
Aree JAMPAKLAY1, Buppha SIRIRASSAMEE1, Charamporn HOLUMYONG1, Ron BORLAND2,
Geoffrey T. FONG3
Mahidol University1, The Cancer Council Victoria2, University of Waterloo3

13:30 - 15:00	Symposium 4
Illness specific issues. 3. Smoking and Heart diseases

Room: 302

S4-01
KeynoteAugust 18

Chairs: Hisayoshi FUJIWARA (Japan)
Tsu-Shing WANG (Taipei)
Smoking and Heart Diseases
Akiyoshi OGIMOTO, Jitsuo HIGAKI
Ehime University

S4-03

Mechanism of Cigarette Smoke Extract-Induced Reorganization of the Actin Cytoskeleton in
Human Endothelial Cells
Bo-Hong LIN, Tsu-Shing WANG
Chung Shan Medical University

S4-04

Relationship between Nicotine Dependence and Carotid Arterial Stiffness in 4,130 Chinese Male
Smokers
Dan XIAO1,2, Chunmei ZHANG1,2, Ruijun GUO1, Zhi’an LI3, Wenli CHEN1,2, Chen WANG2,4,
Pintong HUANG5, Lin MA6
Beijing Chao-Yang Hospital1, World Health Organization Collaboration Center for Tobacco or Health inChina2, Beijing An-Zhen Hospital3, Beijing Hospital, Ministry of Health4, The Second affiliated Hospital of
Zhejiang University School of Medicine5, Hebei United University Affiliated Hospital6

S4-05

The Effect of Second Hand Smoker on High Molecular Weight Adiponectin Levels in Adults
Women: A Preliminary Report
Siti H. MOHD HANAFFI, Harmy MOHAMAD YUSOFF, Norhayati MOHD NOOR,
Aida H. GHULAM RASOOL, Hamid J. JAN MOHAMAD
Universiti Sains Malaysia

August 20

Smoking and Heart Diseases
Kazunori SHIMADA, Hiroyuki DAIDA
Juntendo University

August 19

S4-02

S4-06
Dong Jin OH
KongDong Sacred Heart Hospital, Hallym University
15:00 - 15:30

Break

15:30 - 17:00	Symposium 8
Roles of nurses and other health professionals in the tobacco epidemic

Room: 302

Chairs: Kenji AMAGAI (Japan)
Sophia CHAN (Hong Kong)

August 21

S8-01
KeynoteRoles of Nurses and Healthcare Professionals in the Tobacco Epidemic
Sophia CHAN
Under Secretary for Food and Health, The Hong Kong Special Administrative Region Government

S8-02

Roles of Nurses and Other Health Professionals in the Tobacco Epidemic: Experience of Indonesia
Soewarta KOSEN
National Institute of Health Research & Development

S8-03

Smoking Status and the Kano Test for Social Nicotine Dependence (KTSND) in Employees of a
Regional Cancer Center in Japan
Kenji AMAGAI
Ibaraki Prefectural Central Hospital

31

August 18

S8-04

Epidemiological Study of Smoking among Japanese Physicians
Maki IKEDA1, Yoshitaka KANEITA2, Osamu ITANI1, Satoshi IMAMURA3, Takashi OHIDA1
Nihon University1, Oita University2, Japan Medical Association3

S8-05

Developing a Teaching Module on Tobacco Control for Health Professionals in Malaysia
Amer Siddiq AMER NORDIN1,2, Farizah MOHD HAIRI1, Christopher BULLEN3, Rahimah A. KADIR1,4
University Malaya1, University of Otago2, The University of Auckland3, Lincoln University College4

12:30 - 14:00

Luncheon Seminar
Spomsored by WHO WPRO

Room: 303

During the past few years, there were significant achievements and events resulting from the countries’ efforts
in implementing the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in theWestern Pacific Region. In this panel session, five panelists will introduce experience of countries that have madeprogress in their tobacco control measures and future challenges towards complete enforcement of the WHO FCTC.

August 19

Programme
12:40 - 12:45 Opening remarks
Carmen AUDERA-LOPEZ, WHO WPRO
12:45 - 13:55 Panel Discussion
Format: 10-minute presentations and 20 minutes for discussion- Plain packaging in Australia- Tobacco packaging in ASEAN countries- Tobacco taxation in the Pacific countries- Blue ribbon campaign in the Philippines- Sin tax in the Philippines"
Moderator: Anette DAVID, Health Partners LLC
Panellists: Angela PRATT, WHO China
Bungon RITTHIPHAKDEE, SEATCA
Florante TRINIDAD, WHO Philippines(Pending confirmation from other panellists)
13:55 - 14:00 Closing remarks
Carmen AUDERA-LOPEZ, WHO WPRO
8:30 - 17:15

August 21
32

Action planning and Training of National TB Programme (NTP) Managers on Integrating Brief
Tobacco Interventions into TB treatment Programme in Primary Care
Room:205

August 20 (Tuesday)

Chairs: Tadao SHIMAO (Japan)
Prakit VETHESATOGKIT (Thailand)
PL2-01
KeynoteFighting NCDs Together with Other Health Problems
Douglas W. BETTCHERWorld Health Organization

August 18

9:00 - 10:15	Plenary Lecture 2
Room: International Conference Room
NCD Commitment. Fighting together with other health problems

PL2-02
Keizo TAKEMIHome of Councikkors
Tobacco Control Measures toward 12% of Adult Smoking Rate as National Target under HealthJapan 21 (The 2nd Term)
Hiroyuki NODA
Ministry of Health, Labour and Welfare

PL2-04

Smoking Prevention Strategies: Is Education Enough?
Peter LANDLESSGeneral Conference of Seventh-day Adventist, International Commission for the Prevention of Alcoholism
and Drug Dependency

10:15 - 10:45

August 19

PL2-03Break

10:45 - 12:15	Plenary Lecture 3
Room: International Conference Room
MOF Summit: Price and taxations. Countries’ experiences

August 20

Chairs: Shigefumi MATSUZAWA (Japan)
Ayda Aysun YUREKLI (WHO)PL3-01
KeynoteGlobal Excise Tax Systems and Administration
Ayda YUREKLIWorld Health Organization
Tobacco Taxation in the Pacific-The Tonga Example
Siosifa Tuitupou TUÚTAFAIVA
Minister for Revenue, Tonga

PL3-03

Recent Developments in the Philippines Tobacco Taxation System
Jeremias PAUL
Department of Finance Philippines

PL3-04

Tobacco Taxation in Turkey, a Success StoryÜnal TAYYAN
Ministry of Finance, Republic of Turkey

PL3-05

Tobacco Taxation in Russia and Future Plans
Ilya TRUNIN
Ministry of Finance Russian Federation

August 21

PL3-0233

PL3-06

August 18

Indonesia’s Tobacco Taxation, the Roadmap to Simplify Its Structure
Astera Primanto BHAKTICenter For State Revenue Policy, Fiscal Policy Agency, Ministry of Finance

12:15 - 12:30

Break

13:30 - 15:00

Symposium 9
Treatment of tobacco dependence

Room: International Conference Room

Chairs: Shuichi OTAKE (Japan)
Marewa GLOVER (New Zealand)
S9-01
KeynoteTreating Tobacco Dependence
Richard D. HURT
Nicotine Dependence Center Mayo Clinic

August 19
August 20

S9-02

Smoking Cessation Services in Hong Kong: Combing Public Health Approach and ClinicalApproach
Christine WONG
Hong Kong Special Administrative Region

S9-03

Effectiveness of the Preoperative Smoking Cessation Treatment in Patients with Elective Surgery
Mami IIDA1, Koji ONO1, Hiroki IIDA2, Mayumi KATO2
Gifu Prefectural General Medical Center1, Gifu University Graduate School of Medicine2

S9-04

Are You ready for Cessation? A Conceptual Framework for Building Cessation Capacity
Annette M. DAVID1, Sophia CHAN2, Susan P. MERCADO3
University of Guam1, The University of Hong Kong2, World Health Organization3

S9-05

Emergency Department-initiated Tobacco Control: Systematic Review and Meta-analysis
Bruce NEUNER1,2, Edith WEISS-GERLACH1, Juergen WELLMANN2, Hans-Werner HENSE2,
Gwen L. RABE2, Claudia SPIES1
Charité-Universitaetsmedizin Berlin1, University of Muenster2

S9-06

Brief Smoking Cessation Intervention at Health Examination and Training for Health Professional
Masakazu NAKAMURA
Osaka Center for Cancer and Cardiovascular Diseases Prevention

15:00 - 15:30

Break

15:30 - 17:00

Symposium 13
Room: International Conference Room
Litigation/Regulation of the contents of tobacco products and of tobacco product disclosure

August 21

Chairs: Koki OKAMOTO (Japan)
Ron BORLAND (Australia)
S13-01
Keynote34

Daring to Dream: Policy-makers and Practitioners’ Views of an ‘Endgame’ Solution to Tobacco
Smoking at a Country Level
Richard EDWARDS1, Jo PEACE1, Marie RUSSELL1, Heather GIFFORD2, George THOMSON1,
Nick WILSON1
University of Otago1, Whakauae Research2

S13-02

Tobacco Litigation in South Korea: the Possibility of KT&G Nicotine Manipulation
Sungkyu LEE1, Jaehyung KIM1, Il-Soon KIM2
University of California1, Korean Association of Smoking or Health2

S13-03

Pack Innovation and Product Designs Promoted in ASEAN Countries
Yen Lian TAN 1, Kin FOONG 2
Southeast Asia Tobacco Control Alliance1, Universiti Sains Malaysia2

Laws Regulating Tobacco Products in Japan
Ritsu KATAYAMA
Attorney-at-law, Japan

S13-05Denormalizing the Tobacco Industry One Campaign at a Time
Miranda WANG, Yiqun WU
Campaign for Tobacco-Free Kids, Thinktank Research Center for Health Development, Chinese Association
on Tobacco Control

12:30 - 13:30	Luncheon Seminar 3
Sponsored by Global Smoke Free
Moderator: Yumiko MOCHIZUKI
Speaker: Richard D. HURT
Nicotine Dependence Center Mayo Clinic

Room: 201

David GRAHAMInternational Government Affairs, Johnson & Johnson
13:30 - 15:00	Symposium 10
Education, communication, training and public awarenessRoom: 201

August 19

Yoko KOMIYAMA
Former Minister of Health, Labour and Welfare of JapanThe Yoko Komiyama Policy Research Council

August 18

S13-04Chairs: Yoneatsu OSAKI (Japan)
Zee Yoong KANG (Singapore)
S10-01

Singapore’s Social Movement in Tobacco Control
Zee Yong KANG
Health Promotion Board
The Ripple Effect: Using Subnational Campaigns to Model Success for a National Effort in China
Yu CHEN, Yvette CHANG
World Lung Foundation

S10-03

Trends in Adolescent Smoking Behavior and its Correlates in Japan
Yoneatsu OSAKI1, Takashi OHIDA2, Hideyuki KANDA3, Yoshitaka KANEITA4, Masumi MINOWA5,
Susumu HIGUCHI6, Yoko KONDO1
Tottori University1, Nihon University2, Yokohama City University Graduate School of Medicine3, Oita
University4, Minowa Epidemiolgy Institute5, National Hospital Organization Kurihama Medical andAddiction Center6

S10-04

Smoking Cessation Interventions in Indonesia
Endah D. PRATIWICenter for community Empowerment, Health policy and Humanities National Institute of Health Researchand Development Ministry of Health Republic of Indonesia

S10-05

Impact of Smoke-Free Melaka City Project on Smoking Attitudes among Adult Smokers in Melaka:
Findings from Evaluation of Smoke Free Melaka Intercept StudyYahya BABA1, Maizurah OMAR2, Rahmat AWANG1,2, Noraryana HASSAN3, Nur Hanani JASNI2,
Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH4, Pete DRIEZEN4, Mary THOMPSON4,
Geoffrey T. FONG4MySihat1, Clearinghouse for Tabacco Control2, Melaka State Health Departments3, University of Waterloo4

August 21

S10-02

August 20

Keynote35

S10-06

August 18

Social Marketing Campaign to Support the Implementation of the Comprehensive Smoke Free
Ordinance in Selected Pilot Provinces in the Philippines
Maria Soledad ANTONIO1, Marysol BALANE1, Bill BELLEW2, Jorge ALDAY3
Bureau of International Health Cooperation1, International Union Against Tuberculosis and Lung Diseases2,
World Lung Foundation3

15:00 - 15:30

Break

15:30 - 17:00

Symposium 14
Tobacco industry and Corporate Social Responsibility

Room: 201

Chairs: Mary Assunta KOLANDAI (Australia)
Edgardo Ulysses DOROTHEO (Philippine)
S14-01
KeynoteAugust 19

End Tobacco Industry Corporate Giving
Mary Assunta KOLANDAISoutheast Asia Tobacco Control Alliance (SEATCA)

August 20

S14-02The CSR Conducted by Tobacco Companies in Japan
Masako SHIGETA1,2, Isao WATANABE1, Daisuke MATSUI1,Kaoru INOUE1, Nahomi MIKAMOTO1,
Atsuko AOKI2, Takashi DOI2, Narito KURIOKA2, Tadaaki MORI2, Yuji YASUDA2
Kyoto Prefectural University of Medicine1, Kyoto Association for Tobacco Control2

S14-03

Saveourfarmer.org Website to Counter Tobacco Farming Front Groups
Jennie L. REYES, Sophapan RATANACHEASoutheast Asia Tobacco Control AllianceS14-04

Tracking Investments by Financial Institutions in Tobacco Companies - What Tobacco Control
Advocates Need to Know and Do about It?
Pranay LAL
International Union Against Tuberculosis and Lung DiseaseS14-05South Korea: KT&G Sangsang Univ. Employs CSR for Marketing
Sungkyu LEE, Stanton A GLANTZ
University of California

12:30 - 13:30

Luncheon Seminar 4
Future challenges of tobacco dependence treatment from Japan experience
Sponsored by Novartis

Room: 301

Chair: Akira OSHIMA(Cancer Information Service Osaka Medical Center for Cancer and Cardiovascular
Diseases)

August 21

Speaker: Masakazu NAKAMURA
Osaka Center for Cancer and Cardiovascular Disease Prevention
13:30 - 15:00

Symposium 11
Price and taxations. General discussions
Chairs: Hiroshi NOGAMI (Japan)
Hana ROSS (USA)S11-01
KeynoteS11-0236

De-bunking the Myths of Tobacco Taxation
Hana ROSS
American Cancer Society
Application of Korea SimSmoke to Develop Tobacco Control Strategies
Sung-il CHO
Seoul National University Graduate School of Public Health

Room: 301

S11-04

The Distribution of Cigarette Prices in Different Tax Structures: Findings from the International
Tobacco Control Policy Evaluation (ITC) Project
Ce SHANG1, Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Nahleen ZAHRA1
University of Illinois1, University of Waterloo2, Ontario Institute for Cancer Research3

S11-05

Industry’s Response to Tax Increases: Price Subsidies Under Different Tax Systems andConsequences for Government Tax Revenues and Public Health
Nigar NARGIS1,2, Ayda YUREKLI1World Health Organization1, University of Dhaka2

S11-06

Coordinated Advocacy Campaign to Increase Subnational Taxes in India
Vandana SHAH1, Sanjay SETH1, Virendra SINGH3, Satyen CHATURVEDI2, Jaspreet PAL1,
Hema KHANCHANDANI1Campaign for Tobacco Free Kids1, Rajasthan Voluntary Health Association2, Indian Asthma Care Society3

15:00 - 15:30

Break

15:30 - 17:00	Symposium 15
Packaging and labeling of tobacco products, Countries’ experiences

Room: 301

Chairs: Hiroshi KAWANE (Japan)
Geoffrey FONG (Canada)
S15-01
KeynoteAdvancing Health Warnings Policy with Lessons Learned from Selected ASEAN Countries
Yen Lian TAN
Southeast Asta Tobacco Control AllianceS15-03

Pathways for the Impact of Cigarette Pack Health Warning Labels on Smokers’ Quitting Behaviour:
Findings from the ITC-4 Country Surveys
Hua-Hie YONG1, Ron BORLAND1, Jim F. THRASHER2,3, Geoffrey T. FONG4,5, KM. CUMMINGS6,
Mary E. THOMPSON4
Cancer Council Victoria1, University of South Carolina2, National Institute of Public Health3, University ofWaterloo4, Ontario Institute for Cancer Research5, Medical University of South Carolina6

S15-04

Packaging and Labeling of Tobacco Products in Hong Kong
Vienna LAI
Hong Kong Council on Smoking and Health

S15-05

An Evaluation of the Removal of Tobacco Retail Displays in New Zealand
Gregor WHYTE, Phliip GENDALL, Janet HOEK
University of Otago

S15-06

The Plain Truth: Australia’s World First Plain Packaging Legislation
Kylie. J. LINDORFF
Cancer Council Victoria

August 21

S15-02

August 20

Recent Findings from the ITC Project on the Effectiveness of Health Warnings in the Asia PacificRegion:Geoffrey T. FONG
University of Waterloo

August 19

Effectiveness of Tobacco Tax and Price Policies for Tobacco Control
Frank J. CHALOUPKA
University of Illinois

August 18

S11-0337

August 18

12:30 - 13:30

Luncheon Seminar 4 *Satellite
Sponsored by Novartis

Room: 302

13:30 - 15:00

Symposium 12
Other forms of tobacco / Substances simulating tobacco

Room: 302

Chairs: Gauri DHUMAL (India)
Kazunori NAKAKUKI (Japan)
S12-01
KeynoteAugust 19
August 20

S12-02

Smokeless Tobacco Products and Tobacco Imitations in Japan
Masaaki YAMAOKA
Sumoto Energicenter

S12-03

Areca Nut Epidemic among School Children in Mumbai, India
Nikita SURANI1, Ajay PILANKAR1, Devika CHADHA1, Tshering BHUTIA1, Vaibhav THAWAL2
Salaam Bombay Foundation1, Narotam Sekhsaria Foundation2

S12-04Comparison of Characteristics of E-Cigarette Only Users and Dual Users of Both Cigarettes andE-cigarettes Among Korean Adolescents
Eun Young KIM1, Sun Ha JEE2, Dae Yong KANG2, Ji Eun YOON3
Korea University1, Yonsei University2, National Rehabilitation Center3

S12-05The Current Status and Regulatory System of Electronic Cigarette in Korea
Cheol Min LEE
Seoul National University Hospital

8:30 - 15:30

38

Quit History, Intentions to Quit, and Reasons for Considering Quitting among Tobacco Users inIndia: Findings from the Wave 1 TCP India Survey (2010–11)
Gauri G. DHUMAL1, Mangesh S. PEDNEKAR1, Lalit J. RAUTE1, Prakash C. GUPTA1,
Genevieve SANSONE2, Anne QUAH1, Geoffrey T. FONG2,3
Healis Sekhsaria Institute for Public Health1, University of Waterloo2, Ontario Institute for Cancer
Research3

Action planning and Training of National TB Programme (NTP) Managers on Integrating Brief
Tobacco Interventions into TB treatment Programme in Primary Care
Room:205

August 21 (Wednesday)

Chairs: Makiko YAMAMOTO (Japan)
Mark LEVIN (USA)
PL4-01
KeynotePhilippines: Are We Winning against the Tobacco Industry?
Edgardo Ulysses N. DOROTHEO
Southeast Asia Tobacco Control Alliance, Framework Convention AllianceTobacco Control in Japan. What It Is and What It Should Be.
Manabu SAKUTA
Japan Society for Tobacco Control

PL4-03

FCTC Implementation in South Korea, Still Have a Long Way To Go
Hong Gwan SEO
National Cancer Control Institute, National Cancer Center

10:30 - 11:00

Break

11:00 - 12:30	Symposium 16
Room: International Conference Room
Issues of trade and tobacco market opening and APACT: Ending the game
Chairs: Judith MACKAY (Hong Kong)
Prakit VETHESATOGKIT (Thailand)
S16-01
KeynoteThe Globalization of the Tobacco Industry and Implications for Tobacco Control
Frank J. CHALOUPKA
University of Illinois

S16-03

Tobacco Trade in the ASEAN Region: Transit Points and AFTA
Anthony D. SO, Ryan C. DENNISTON
Program on Global Health and Technology Access1, Duke Global Health Institute2

S16-04

Does Tobacco Taxation Have an Influence on Industry Consolidation?
Anne-Marie PERUCIC, Nigar NARGIS, Ayda Aysun YUREKLIWorld Health Organization

S16-05The Economic Integration and its Threat to Tobacco Taxation: The Case of ASEAN Economic
Community
Sophapan RATANACHENA, Jennie L. REYESSoutheast Asia Tobacco Control Alliance

12:30 - 13:00

Closing Ceremony

Room: International Conference Room

14:30 - 16:00

A Lecture Open to the Public

Room: International Conference Room

39

August 21

S16-02

August 20

Tobacco Proposal in a 21st Century Free Trade Agreement
Deborah SY
Havison Institute Georgetown University Law Center

August 19

PL4-02

August 18

9:00 - 10:30	Plenary Lecture 4
Room: International Conference Room
Where are we with FCTC ? (2) Obstacles and ways to overcome them

11:00 - 12:30

August 18

Symposium 17
Room: 201
Protection of public health policies from commercial and other vested interests of the tobacco
industry / Liability
Chairs: Ritsu KATAYAMA (Japan)
Mark LEVIN (USA)Pei-kan YANG (Taipei)

S17-01
KeynoteHow Does Big Tobacco Love Government Interference?
Let Us Count the Ways
Mark LEVIN
Univesity of Hawaii

August 19
August 20

S17-02

What Hinders Implementation of the WHO FCTC Article 5.3 in South Korea ?
Sungkyu LEE
Center for Tobacco Control Research and Education, University of California

S17-03

Non-Compliance with FCTC Article 5.3 and Article 19 in Japan
Koki OKAMOTO
Lawyer

S17-04

New Zealand Smokers’ and Non-Smokers’ Support for End-Game Retail Policies
Philip GENDALL, Gregor WHYTE, Janet HOEK
University of Otago

S17-05

Tobacco Industry’s Tactics to Challenge Effective Tobacco Control Activities from a View Point of
Product Innovation
Yumiko MOCHIZUKI-KOBAYASHINational Cancer Center

S17-06

Legal Implications of WHO/FCTC Declarations on Tobacco Disputes under WTO and BITs: How
Could They Help Parties Fighting against Tobacco Industry?
Pei-Kan YANG
National Chengchi University

11:00 - 12:30

Symposium 18
Room: 301
Inequities in tobacco use and tobacco control and its implication for tobacco control
Chairs: Yayi Suryo PRABANDARI (Indonesia)
Geoffery FONG (Canada)

S18-01
KeynoteAugust 21
40

Inequities in Tobacco Use and Tobacco Control and its Implication for Tobacco Control
Hong-Jun CHO
University of Ulsan College of Medicine

S18-02

A Health Inequities Challenge for Tobacco Control in Indonesia: Who Smoke More in the Last
Decade?
Yayi S PRABANDARI
Universitas Gadjah Mada

S18-03

Cigarette Consumption and Quitting Behaviour among Smokers in China: Finding from ITC China
SurveyJilan YANG1, David HAMMOND1, Susan HORTON1, Geoffery FONG1,2, Yuan JIANG3
University of Waterloo1, Ontario Institute for Cancer Research2, Chinese Center for Disease Control andPrevention3

Incorporating National Tobacco Control Laws into Existing Sub-national Governance Mechanisms:
A New Approach to FCTC Implementation in India
Vandana SHAH1, Tarkeshwar Prasad SINGH2, Sanjay SETH1, Arvind SINGH2, Hema KHANCHANDANI1Campaign for Tobacco Free Kids1, Cancer Awareness Society - Bihar, India2

S18-05

Play the Role of Non-governmental Organisations, Fight against Tobacco Industry Interferencewith Tobacco Control
Guihua XU
Chinese Association on Tabacco Control

11:00 - 12:30	Symposium 19
APACT Youth for the future demand

Room: 302

August 18

S18-04Chairs: Nicole SUTTON (USA)Haruka SAKAMOTO (Japan)

S19-02Adolescent Awareness of a Tobacco Promotion in Malaysia and Thailand: Findings from the ITC
SEA Project
Maizurah OMAR1, Rahmat AWANG1, Noor A. A. RANI1, Haslina HASHIM1, Halilol R. KHAN1,
Sulastri SAMSUDIN1, Buppha SIRIRASSAMEE2, Anne C. K. QUAH3, Geoffrey T. FONG3,4,
Ron BORLAND5
Universiti Sains Malaysia1, Mahidol University2, University of Waterloo3, Ontario Institute for Cancer
Research4, The Cancer Council Victoria5

S19-03Engaging Children for Tobacco – Free Schools
Tshering D. BHUTIA, Narayan LAD, Devika CHADHA
Salaam Bombay Foundation

S19-04

Qualitative Analysis of Factors Affecting the Difficulty Quit Smoking of Students State Islamic
University Jakarta
Ahmad R. NUBAIRI, Mochamad I. NURMANSYAH, Badra AL- AUFA, Erna WATI,
Waras BUDI UTOMO
Syarif Hidayatullah Islamic State University of Jakarta

S19-05

United for Tobacco Free World. “What should WE do?”Apact YOUTH

August 20

Nicole M. SUTTON
REAL: Hawaii Youth Movement Exposing the Tobacco Industry, University of Hawaii

August 19

S19-01
KeynoteAugust 21
41

A Lecture Open to Public

August 18＊Japanese Only

市民公開講座PM2.5とタバコの害について～あなたの疑問に答えます～

August 19

日時：8月21日（水）14:30～16:00

入場無料

場所：千葉・幕張メッセ国際会議場 2階国際会議室
公共交通機関でお越しください）
アクセス：海浜幕張駅徒歩10分 ＊駐車場なし（公共交通機関でお越しください）
定員：３００名

August 20

プログラム：
主催者あいさつ （千葉県）（14:30～14:35）
基調講演 「測ってみてわかったPM2.5とタバコの害」
産業医科大学産業生態科学研究所 教授 大和 浩
（14:35～15:05）
特別発言 「喫煙・受動喫煙の有害性が理解されないのはなぜか」
中央内科クリニック 院長
村松 弘康（15:05～15:20）
対談（15:20～15:40）
イベント あなたの肺は何歳ですか？
肺年齢測定体験会 先着100名（申込制）＊18歳以上の方を対象にしています。

（15:40～16:00）

August 21

主催 千葉県・APACT2013（第10回アジア太平洋タバコ対策会議）
目的 タバコのない社会をめざして－健全な命を守るために－をテーマにアジア・太平洋からタバコ対策に関心のある人々がこの千葉県に集まって会議を開きます。
千葉県民としてもタバコの害、PM2.5の害について学ぶ機会をつくり、県民と健全な命を守るためにどのようなことができるかを考える場にしたいと考えて企画されています。

企画内容のお問い合わせ：APACT Japan事務局（日本禁煙学会）〒162-0063東京都新宿区市谷薬王寺町30－5－201
電話： 03-5360-8233 FAX： 03-5360-6736
E-mail: desk@apact.jp
お申し込みに関するお問い合わせ：千葉県健康福祉部健康づくり支援課
電話０４３－２２３－２６６０ FAX０４３－２２５－０３２２
E-mail: kenpro@mz.pref.chiba.lg.jp

42

Poster Program
P-PL1-01

Effective Nationwide Networking and Social Movement in Aotearoa New Zealand
Prudence STONE1, Stephanie ERICK2, Skye KIMURA3
Smokefree Coalition1, Tala Pasifika2, Cancer Society of New Zealand3

P-PL1-02

Tobacco Industry Surveillance Network in Southeast Asia: Stepping Up Tobacco Industry
Counteraction
Worrawan JIRATHANAPIWATSoutheast Asia Tobacco Control Alliance

P-PL1-03

Prevalence of Smoking in Students of Chulalongkorn University
Premtip THAVEERATITHAM, Nampung KUMSUPSIRI, Pantawit ARIYAWORACHAI,
Prapon RUJIPORN, Thongsuk MANITSORN
Chulalongkorn University

P-PL1-04

Situation and Trends of Adolescent Smoking in Thailand: Results from 5 Waves of ITC-SEA(Thailand) Surveys
Pariya GAINROJ1, Buppha SIRIRASSAMEE1, Tawima SIRIRASSAMEE2, Ron BORLAND3,
Geoffrey T. FONG4, David HAMMOND4
Mahidol University1, Srinakarinwirot University2, The Cancer Council Victoria3, University of Waterloo4

P-PL1-05

Monitoring Political Discourse around End-game Goals: Using a Mix of Automated and Human
Textual Analysis to Enable an On-going Overview
Benjamin HEALEY, Richard EDWARDS, Janet HOEK
University of Otago

P-PL2-01

Effects of Parental Smoking during Pregnancy on Development of Childhood Cancers
Fumio BESSHO, Masako TANIMURA
Kyorin University

P-PL2-02

Broadening the Scope from TC to NCDs, Ideas and a Case Study
Syed Mahbubul ALAM, Gaous PEAREE, Syeda Anonna RAHMAN, Rashedujjaman SHAMIM,
Sharmin AKHTER
Work for a Better Bangladesh TrustP-PL2-03

Role of Tobacco Control Resource Center Project on Public Awareness Regarding Smoking
Phenprapa CHILAKUL1,2,3, Mondha KENGGANPANICH2
Action on Smoking and Health Foundation1, Mahidol University2, ThaiHealth Promotion Foundation3

P-PL2-04

The Effectiveness of the Motivational Interviewing Program Related to the Smoking Cessation
among Health Care Providers, At Sanpasitthiprasong Hospital, Ubonratchathani Province Thailand
Wanpen DOUNGMALA, Wantanee THONGNUN, Malee NIMPONGPAN, Kwanpat RAUNGSIT,
Supathita KONGSIN, Paungthong TECHASIRIKOSOL, Kannika CHANTARUKHA,
Jamchan POUNGCHAN
Sanpasithiprasong Hospital

P-PL2-05

What is Necessary to Make Smoke-free Society in Japan?
Kazunari SATOMURA, Toshitaka NAKAHARA, Suketaka IWANAGA, Megumi NOAMI,
Keiko KUSAKA, Kazuyoshi HARANO
Kyoto University

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P-PL3-01

The Impact of 2009 China Cigarette Tax Adjustment on Cigarette Retail Prices, Cigarette Class/
Grade Choice and Cigarette Consumption
Jidong HUANG1, Rong ZHENG2, Frank J. CHALOUPKA1, Geoffrey FONG3,5, Qiang LI3, Yuan JIANG4
University of Illinois at Chicago1, University of International Business and Economics2, University ofWaterloo3, Chinese Center for Disease Control and Prevention4, Ontario Institute for Cancer Research5

P-PL3-02

Cigarette Retail Price Variations in China: Evidence from the International Tobacco Control China
SurveyJidong HUANG1, Rong ZHENG2, Frank J. CHALOUPKA1, Geoffrey FONG3,5, Qiang LI3, Yuan JIANG4
University of Illinois1, University of International Business and Economics2, University of Waterloo3,
Chinese Center for Disease Control and Prevention4, Ontario Institute for Cancer Research5

P-PL3-03

Communication Strategy on Tobacco Tax Reforms: The Philippines’ Experience
Florante E. TRINIDAD
World Health Organization Office of the Representative in the Philippines

P-PL3-04

How Much the Appropriate Tobacco Price Would be? -Conjoint Analysis for GENERAL Public inJapanAtaru IGARASHI1, Rei GOTO2
The University of Tokyo1, Kyoto University2

P-PL3-05

How Much Various Anti-Tobacco Policies Would Affect Smokers' Attitudes? -Conjoint Analysis in
Japan
Ataru IGARASHI1, Rei GOTO2, Takashi FUKUDA3The University of Tokyo1, Kyoto University2, National Institute of Public Health3

P-PL3-06

Is Employment in Bidi Manufacturing a Concern for Bidi Taxation?
Nigar NARGIS, Ayda A YUREKLIWorld Health Organization

P-PL3-07

The Impact of Cigarette Tax and Price Policy on Tobacco Industry Behavior ---Disclosing theIndurstry’s Profit Margin in Each Segment
Rong ZHENG1, Jidong HUANG2, Song GAO3, Frank J. CHALOUPKA2, Geoffrey T. FONG4,5, Qiang LI4,6,
Yuan JIANG6
University of International Business and Economics1, University of Illinois at Chicago2, Central Universityof Finance and Economics3, University of Waterloo4, Ontarion Institute for Cancer Research5, ChineseCenter for Disease Control and Prevention6

P-PL3-08

Contribution of Sale to Minors to Tobacco Industry and Government Revenues - A Case of India
Pranay LAL, Sonu GOEL, Deepak SHARMAInternational Union Against Tuberculosis and Lung Disease, Postgraduate Institute of Medical Education &Research

P-PL3-09

Improper Tobacco Taxation Benefiting the Tobacco Industry in Bangladesh
Taifur RAHMAN
Campaign for Tobacco-Free Kids

P-PL3-10

The Impact of Tobacco Tax Increase on Affordability Revenue and the Implication for Tax Policy in
VietnamHoang Anh T. PHAM1, Hien T. LE1, Nam V. HUYNH2, Vang V. DANG2
HealthBridge Canada1, Ministry of Finance2

P-PL3-11

Increase of Income of the Sales Profit and Tax Revenues by the Price Increase (Tax-rates Raising)of the Tobacco from October, 2010
Hiroshi NOGAMI
Coalition on a Smoke-free Environment for Kids in Japan

P-PL3-12

Low Cost of Manufactured Cigarettes in Cambodia Targets the Poorest and Youngest Smokers
Daravuth YEL1, They KHEAM2, Pramil N. SINGH3
World Health Organization1, Ministry of Planning2, Loma Linda University3

P-PL3-13

Analyzis of Tobacco Excise Policy in Indonesia : Bringing the Health Objectives Back In
Abdillah AHSAN
University of Indonesia

P-PL3-14

Curbing Tobacco Epidemics by Tobacco Taxation in Lao PDR
Maniphanh VONGPHOSY, Sophapan RATANACHENA, Jennie L. REYESSoutheast Asia Tobacco Control Alliance

P-PL3-15

High-priced Smuggled Cigarettes: the Case of Vietnam
Minh T. NGUYEN1, Son T. DAO2, Nga Q. NGUYEN3
University of Illinois at Chicago1, Center for Economics and Community Development2, Massey University3

P-PL3-16

Perverse Economics of Tobacco Trade in India
Pranay LAL
International Union Against Tuberculosis and Lung Disease

P-PL3-17

Cigarette Price and Retailer Survey in the Philippines
Irene Patricia N. REYES, Ralph Emerson P. DEGOLLACION, Nichola L. LIBORO
Health Justice Philippines

P-PL4-01

Smoking Reduces Life Expectancy in Japanese the Same as Other Populations
Ritsu SAKATA1, Paul MCGALE2, Eric J. GRANT1, Kotaro OZASA1, Richard PETO2, Sarah C. DARBY2
Radiation Effects Research Foundation1, University of Oxford2

P-PL4-02

FCTC COP5 Outcomes and Work towards a Successful COP6
Edgardo Ulysses DOROTHEOSEATCA Southeast Asia Initiative on Tobacco Tax, Southeast Asia Tobacco Control Alliance

P-PL4-03

Empowering Health Workers to Become Change Agents to Support Rural Communities to Fight
TobaccoDeepak J. PATIL, Rajashree S. KADAM, Devika M. CHADHA
Salaam Bombay Foundation

P-PL4-04

Tobacco Smoking and Poverty in the Fertile Female Population
Andrea Z. FOGARASI-GRENCZER1, Ildikŏ RĂKŎCZI2, Kristie L. FOLEY3, Pĕter BALĂZS1
Semmelweis University1, University of Debrecen2, Davidson College3

P-PL4-05

Looking at Policy Change at the Provincial Level in China
Xia WAN1, Frances STILLMAN2, Xiaochang ZHANG3, Mark SPIRES2, Zhen DAI1, Stephen TAMPLIN2,
Jonathan M. SAMET4, Gonghuan YANG1,3
Peking Union Medical College1, Johns Hopkins University2, Chinese Centers for Disease Control andPrevention3, University of Southern California4

P-PL4-06

Changing Tobacco Control Policy in Southeast Asia: The Power of a Regional Collaboration
Yen L. TAN, Bungon RITTHIPHAKDEE
Southeast Asia Tobacco Control Alliance

P-PL4-07

The Economic Impacts of Tobacco vis-à-vis Rice Farming and Implications on Agricultural
Development Planning: A Case Study in the Philippines
Jennie Lyn C. REYESSoutheast Asia Tobacco Control Alliance

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P-PL4-08

Coordinated Legal, Political and Media Advocacy to Ban Gutka (Smokeless Tobacco) in India
Vandana SHAH1, Pankaj CHATURVEDI2, Vijay Anand R. PALKONDA3, Sanjay SETH1, Jaspreet K. PAL1
Campaign for Tobacco Free Kids1, Tata Memorial Hospital2, Apollo Hospitals3

P-PL4-09

Crop Substitution: A Case Study of Bangladesh
Shameem H. PATWARY
Dhaka International University, Supreme Court Bar Association, Humanist and Ethical Association of
Bangladesh

P-PL4-10

The Recognition of Smoke-Free Legislation: Attitudes of the Hotel Staffs Towards Non-Smoking
Environments in Chiba
Masako TANAMURA1, Kazunori NAKAKUKI1, Yukio KATSUMI2
Healthcare Professionals Association against Tobacco in Chiba1, Smoke-Free kids2

P-PL4-11

The Direction of Tobacco Countermeasure which was Showed in the Opinion Pool of the Citizens
Investigated in Matsuyama City in Japan
Kaori HIROHASHI1, Fumiko KAIDA1, Seiji FUJIOKA2, Yoshihiro TAKAISHI1
Hojo Hospital1, Akari Clinic2

P-PL4-12Indonesian Compliance to Framework Convention on Tobaco Control (FCTC)
Soewarta KOSEN
National Institute of Health Research & Development

P-PL4-13

Can India Facilitate Diversification from Tobacco Dependent Employment?
Research Findings from an All India Study on Tobacco Growers, Bidi Rollers and Tendu Leaf
Pluckers
Nayanatara S. NAYAK, Dattatreya R. REVANKAR, Narayan N. BILLAVA
Centre for Multi Disciplinary Development Research

P-PL4-14

TFAJ, Tobacco-Free Advocacy Japan, its Agenda & Activity
Jun SONO, Masahiro KANEKO, Hajime I. SONO, Fumiro TAKEMOTO, Hiroko TODA,
Shigeki TOYOTA, Hidekazu NAKAGAWA, Hiroshi MATSUOKA, Yuji KUNIMI
Tobacco-Free Advocacy Japan

P-PL4-15

Challenges to Tobacco Taxation Implementation in the Pacific
Matthew ALLEN2, Amelia DALLEY2, James RARICK1, Mina KASHIWABARA1, Ada MOADSIRI1World Health Organization1, Allen and Clarke Policy and Regulatory Specialists Ltd2

P-PL4-16

Strengthening Tobacco Advertising Promotion and Sponsorship Ban in Bangladesh
Arif SIKDER
Environment Council Bangladesh

P-PL4-17

Support for Quitting Smoking to Adolescents at a Pharmacy in Japan
Katsushi MURAYAMA
Murayama Pharmacy

P-PL4-18

Supporting Pacific Island Countries to Strengthen Their Resistance to Tobacco Industry
Interference in Tobacco Control
Judith MCCOOL1, Jeanie MCKENZIE2, Mathew ALLEN3, Annabel LYMAN4
University of Auckland1, Secretariat of the Pacific Communities2, Allen and Clarke3, Framework Convention
Alliance4

P-S1-01

Secondhand Smoke Exposure in Cars and Homes is Associated with Susceptibility to Smoking in
14-15 Year Old Children: Repeated National Survey Data
Benjamin HEALEY1, Richard EDWARDS1, Nick WILSON1, George THOMSON1, Janet HOEK1,Steve TAYLOR2
University of Otago1, AUT University2

P-S1-02

The Impact of Designated Smoking Areas in Where Outdoor Smoking is Banned: The Case of
Kobe City
Hiroshi YAMATO1, Nagisa MORI2, Rumi HORIE3, Loïc GARÇON2, Mihoko TANIGUCHI4,
Francisco ARMADA2
University of Occupational and Environmental Health1, WHO2, The World Bank3, Kobe Pharmaceutical
University4P-S1-03

Smoke-free Policy Development Using Air Pollution Control as an Entry Point: A Case in Jakarta,
Indonesia
Dollaris R. SUHADI1, Tara S. BAM2, Moch. Tauchid TJAKRA AMIDJAJA3, Mara O. SIREGAR3
Swisscontact Indonesia Foundation1, International Union Against Tuberculosis and Lung Disease2, Special
Capital Region of Jakarta Province3

P-S1-04

How Bloomberg Grants Programme Prioritised and Accelerated FCTC/MPOWER Implementationin India?
Jugdeep S. RANA, Pranay G. LAL
International Union Against Tuberculosis and Lung Disease

P-S1-05

The Pattern of Rural Retailer’s Behavioral Concerning Cigarette Sale to Minors in The Lower
Northern Thailand
Chakgarphan PHETPHOOM, Piyarat NIMPITAKPONG, Narongsak NOOSORN
Naresuan University

P-S1-06

Barriers for Local Governments in Japan to Control Tobacco: The Example of Hyogo
Keiko YAMADA1,2, Nagisa MORI1, Mina KASHIWABARA1, Rumi HORIE3, Hiroshi YAMATO4,
Sakiko YASUDA5, Francisco ARMADA1, Loïc GARÇON1
WHO1, Hyogo Prefectural Government2, The World Bank3, University of Occupational and Environmental
Health4, Kyoto University5

P-S1-07

People's Initiatives in Making Smoke Free Public Places: Case Study of Banke & Ilam Districts of
Nepal
Shanta L. MULMI
Resource Centre for Primary Health Care

P-S1-08

En Route to the Enactment of Smoke-free Legislation in Kyoto
Narito KURIOKA1, Yuji YASUDA1, Masako SHIGETA1, Takashi DOI1, Atsuko AOKI1,
Yoko KINOSHITA1, Yoshitsugu TANAKA1, Sumiko KURIOKA2
Kyoto Association for Tobacco Control1, University of Occupational and Environmental Health2

P-S1-09

The Quality of Tobacco Free Zone Regulation in Three Provinces with Special Autonomy Status inIndonesia
Susy K. SEBAYANG1,2, Rizanna ROSEMARY2,3, Wulan A. SEBASTIAN4, JUANITA5
SUMMIT Institute of Development1, International Centre for Aceh and Indian Ocean Studies2, University ofSyiah Kuala3, University of Sydney4, University of Sumatera Utara5

P-S1-10“Kyoto-based Tobacco-Free Caravan” Collaborated with Organizations, Universities, and Local
Governments -Part2Takashi DOI1,2,5, Masako SHIGETA1,2,3, Daisuke MATSUI1,3, Isao WATANABE1,3, Narito KURIOKA1,2,
Yoshitsugu TANAKA1,2, Atsuko AOKI1, Yasufumi OOKITA4
Kyoto Association for Tobacco Control1, Kyoto Medical Association2, Kyoto Prefectural University of
Medicine3, Kyoto City Board of Education4, Doi Internal Medicine Clinic5

P-S1-11

Health Impact Assessment of the "Smoke-free Policy" in Gwangmyeong City
Mee-Kyung SUH1, Seoung-ryul KIM2
Korea Institute for Health and Social Affairs1, Suncheonhyung University2

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P-S1-12Current State and Future Prospect of FCTC in Taiwan
Sea- Wain YAUJohn Tung Foundation

P-S1-13

How NGOs Confront Tobacco Industry and Press Government to Effectively Enforce the Tobacco
Hazards Prevention Act
Sea- Wain YAU, Ted T. L. CHEN, Ching-Li LINJohn Tung Foundation

P-S1-14

Awareness and Support of 100% Smoke Free Indoor Area in Jakarta
Abdillah AHSAN, Ayke S. KITING, Nurhadi WIYONO
University of Indonesia

P-S3-01

Periodontal Disease, Education and Training of Dental Professionals, and Tobacco Control
Takashi HANIOKA
Fukuoka Dental College

P-S3-02

The Study of Oral Lesion Screening and Smoking Habit among Thais
Piyada PRASERTSOM1, Nontinee TANGCHAROENDEE1, Siripen ARUNPRAPHAN2,
Waranun BUAJEEB3
Bureau of Public Health1, Thai Dentist against Tobacco Project2, Mahidol University3

P-S3-03

Comparison of the Cases of Oral Cancer and Potentially Malignant Disorders (Erythroplakia andLeukoplakia) Reported in 2009 and after Launching an Oral Lesion Screening Program in Thailand
in 2011
Nontinee TANGCHAROENDEE1, Piyada PRASERTSOM1, Sompid KINTARAK2,
Kanokporn BHALANG3, Wikul WISALSETH1
Department of Health Ministry of Public Health1, Songkhlanakarin University2, Faculty of Dentistry,
Chulalongkorn University3

P-S3-04

Chemical Evaluation of 3 Different Electronic Cigarette Cartridges and Assessment of Knowledge,
Attitude and Practice Regarding E-Cigarette amongst its users in Pune City, India
Sushil A. PHANSOPKAR, Arishka DEVADIGA, Sahana HEGDE-SHETIYA, Simpy MAHULI,
Amit MAHULI, Deepti AGARWAL
Dr. D. Y. Patil Dental College and Hospital

P-S3-05

Smoking Cessation Environment 2012, According to the 4 Fields of Dentistry in Japan
Kazunori. NAKAKUKI, Shuichi TSUBURA, Jun KITAGAWA, Kazumasa ABE, Toshio SAITOH
Nakakuki Dental Clinic

P-S4-01

The Smoke Risk for Ischemic and Hemorrhage Stroke Mortality
Chi-Pang WEN, Shiuan Bei WU, Min-Kuang TSAI
National Health Research Institutes, China Medical University Hospital

P-S4-02

Smoking Cessation Reduces Oxidative Stress Measured by Salivary Oxidation-reduction
Potentials.
Koji HASEGAWA1, Noa NAGAOKA1, Hiromichi WADA1, Sayaka SHIMADA1, Maki KOMIYAMA1,
Yuko IIDA1, Hajime YAMAKAGE1, Noriko ASAHARA1, Akira SHIMATSU1, Yuko TAKAHASHI2
Kyoto Medical Center, National Hospital Organization1, Nara Women's University2

P-S4-03

Impact of the Passive Smoking on Vasospastic Angina –Analysis of the Urinary CotinineKazuhisa NISHIMURA1, Takayuki NAGAI1, Ogimoto AKIYOSHI1, Jitsuo HIGAKI1, Haruhiko HIGASHI2
Ehime University graduate school of medicine1, Kitaishikai Hospital2

P-S4-04

The Effect of Smoking on Body Weight and Glucose Metabolism
Chisato MURATA
Tokyo Saiseikai Central Hospital

P-S4-05

Outcomes of a Smoking Cessation Clinic in Cardiology Services, Vancouver, Canada
Chizimuzo T. C. OKOLI1, Milan KHARA2
University of Kentucky1, Vancouver General Hospital2

P-S4-06

Heavy Metals, Toxic and Antioxidant Trace Elements in Tobacco Smoking
Duangkamol VIROONUDOMPHOL1, Lerson SUWANTON2, Umaporn PINYOSIRIKUL2,
Siranee SATSUE2, Talabporn HARNROONGROJ2National Institute of Metrology1, Mahidol University2

P-S4-07

Improvement of Blood Mobility at One Year after Smoking Cessation
Sayaka SHIMADA, Koji HASEGAWA, Hiromichi WADA, Sachiko TERASHIMA, Noriko ASAHARA,
Hajime YAMAKAGE, Maki KOMIYAMA, Masaru AKAO, Akira SHIMATSU, Yuko TAKAHASHI
Sapporo Social Insurance General Hospital

P-S4-08

The Difference of Total Cholesterol between Male Tobacco Smokers and Male Tobacco Nonsmokers 20-60 Years Old in Salemba during Year 2009-2010
Atikah I. FATYA
Universitas Indonesia

P-S4-09

Exposure to Secondhand Smoke among Employed Male Japanese Coronary Heart Disease
Patients and the Control of Smoking in Their Workplaces
Yoko MATSUNAMI, Midori FURUSE
Yamagata University

P-S4-10The Relationship of Smoking Dependence with Blood Pressure, Physical Activity and Body
Fatness among Healthy Male Smokers
Zulhusni SUHAIMI, Zuikefli SANIP, Hamid JAN MOHAMED, Hamy MOHAMED YUSOFF
Universiti Sains Malaysia

P-S4-11

Smoking and Passive Smoking Result in Atheroma Generation in Japanese Women Without Risk
Factors
Ichiro SAKUMA
Caress Sapporo Hokko Memorial Clinic

P-S4-12

Change of Central Blood Pressure Before and After Varenicline Therapy
Nobuhisa YAMADA
Yamada-Kikuchi Clinic

P-S5-01

The Poster Contest of Non-smoking Promotion, and the Spread Enterprise of Picture-slide Shows
on the Internet
Hiroshi NOGAMI
Coalition on a Smoke-free Environment for Kids in Japan

P-S5-02

Awareness of Street Smoking Ban Regulation in Kobe City: Results of Interviews from a
Pedestrian SurveyLoïc GARÇON1, Hiroshi YAMATO2, Mihoko TANIGUCHI3, Kana SASAKI3, Aki ONISHI3,
Ayaka HAMAMOTO3, Nagisa MORI1, Rumi HORIE4, Mina KASHIWABARA1, Noriaki EMOTO3
WHO1, University of Occupational and Environmental Health2, Kobe Pharmaceutical University3, The
World Bank4

P-S5-03

Assessing the Compliance of the Ordinance Banning Smoking on Selected Streets in Kobe City,
Hyogo, Japan
Nagisa MORI1, Mihoko TANIGUCHI2, Rumi HORIE3, Mina KASHIWABARA1, Eriko DOI2,
Misato KUSUMOTO2, Sakiko SHIMAI2, Keiko YAMADA4, Loïc GARÇON1, Noriaki EMOTO2
WHO1, Kobe Pharmaceutical University2, The World Bank3, Hyogo Prefectural Government4

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P-S5-04

Home and Workplace Smoking Bans and Support for Public Smoke-free Policy among Adult
Smokers in Thailand: Findings from the International Tobacco Control Thailand Survey
Charamporn HOLUMYONG1, Ron BORLAND2, Buppha SIRIRASSAMEE1, Aree JAMPAKLAY1,
Teeranoot KONKEAW1
Mahidol University1, The Cancer Council Victoria2

P-S5-05

Taipei City Citizens’ Approval Ratings for Building a Smoke-free Environment and Factors
Influencing the Ratings
Li-Ju LIN, Jen-Tao LIU, Yu-Chiu CHI, Li-Hui YU, Hsiu-Lian LIN
Taipei City Goverment

P-S5-06

Pilot Program of Creating 100% Smoke-free Schools in Beijing, Zhengzhou and Kaifeng of China
Ni JINGHUA
Chinese Association on Tobacco Control

P-S5-07

Analysis of Smoking Status and Motivation for Smoking Cessation before and after Establishmentof a Tobacco-free Campus at a University Hospital
Yujiro TAKAI1, Keigo TAKAGI1, Toshisuke MORITA2, Sakae HOMMA1
Toho University Omori Medical Center1, Toho University2

P-S5-08

Smoking Restriction and Amount of Daily Cigarette Consumption among Adult Smoker: Findings
from Waves 1-5 of ITC-SEA (Thailand)
Teeranoot KONKAEW1, Buppha SIRIRASSAMEE1, Aree JAMPAKLAY1, Charamporn HOLUMYONG1,
Ron BORLAND2, Geoffrey T. FONG3
Mahidol University1, The Cancer Council Victoria2, University of Waterloo3

P-S5-09

Initiatives Following the Prohibition of Smoking in a Hospital and its Grounds
Yoshinobu HATA, Shinich MATSUOKA, Masaaki ADACHI, Kimiyoshi MITSUHASHI,
Junichi YOSHIDA, Emiko NAGASAWA, Yukiko MATOBA, Tomio SUGISAKI, Fumiaki SASAKI
Sapporo Social Insurance General Hospital

P-S5-10Perceptions and Misperceptions of a Smokefree Goal: Challenges for Communications
Janet HOEK, Philip GENDALL, Gregor WHYTE
University of Otago

P-S5-11

Result of Investigation about Smoke-Free Environment of Institutions in Chiba Prefecture, Japanand Consideration to Achieve Smoke-Free Environment
Ayumu BENITANI, Keiichi HOSHINO, Yasushi AIHARA
Tobacco Mondai wo Kangaeru Kai

P-S5-12Singapore’s Blue Ribbon Smoke-free Movement in the Hotel Industry
Janelle CHIA, Chris CHEAH, Annie LING
Health Promotion Board

P-S5-13

Evaluation of Smoking Recognition among Health Officers of Japanese Companies by Using the
Kano Test for Social Nicotine Dependence (KTSND)
Yoko MATSUNAMI1, Atsuko KAWAI2
Yamagata University1, Koutokukai Total Health Clinic2

P-S5-14

Assessing Tobacco Smoke Situation around Smokers and Second Handed Smokers in Hospital
StaffsPongsri SRIMORAGOT1,2, Ittipol PAU-ARMART3
Thai Nurses Network on Tobacco Control1, Mahidol University2, Ministry of National Resources andEnvironment3

P-S5-15

Space Separation Is Ineffective to Prevent Passive Smoking
Masayuki TAKAHASHI, Natsuki KINOSHITA
Biwako Seikei Sport College

P-S5-16

Analysis of Dynamics in Smoking Status in Japanese Workers
Yasushi ISOJIMA, Tetsuya TERADA, Takashi KIMURA
Foundation of Kinki Health Administration center

P-S6-01

Association between Smoking and Tuberculosis Infection
Hitoshi TAGAWA1,2, Naoko TEZUKA1,2, Emina FURUTANI1,2, Tomoaki NAKAZONO1,
Kyoko TAKAYANAGI1, Masashi INOUE1,2, Hiroko MUTSUKAWA1,2, Hironobu SUGITA1,2,
Akira OKAYAMA1,2, Tadao SHIMAO1,2
Japan Anti-tuberculosis Association1, Daiichi Dispensary2

P-S7-01

Smoking Habits among Pregnant Women in Hungary
Iidiko RÁKÓCZI1, Andrea FOGARASI-GRENCZER2, Peter TAKÁCS1, K. L. FOLEY3, Peter BALAZS2
University of Debrecen1, Semmelweis University2, Davidson College3

P-S7-02

Health Risks of Second-Hand Smoke on Women in Sukhothai Province, Thailand
Sane SAENGNGERN1, Naroongsak NOOSORN2, Somkid TUNTIWITAYAPAN1
Sukhothai Provincial of Public Health Office1, Naresuan university2

P-S7-03

The Risk Factor of Smoking on Birth Outcomes
Nan Hee YEE1
Korea Institute for Health and Social Affairs

P-S7-04

Effects of Age at Smoking Initiation of Pregnant Women on Subsequent Smoking Habits
Fumiaki SUZUKI1, Takahiro KASAMATSU2
Taniguchi Hospital1, Kobe City College of Nursing2

P-S7-05

Decrease of Pregnant Smokers and Changing of Exposure to Environmental Tobacco Smoke in
Pregnant Women
Masaaki YAMAOKA
Sumoto Emergicenter

P-S7-06

Effects of Maternal Smoking to the Smoking Intention and to The Attachment Formation of Minors
in Japan
Keiko AOISHI1, Ikuyo FUJIMARU2, Toshiharu ETO1
Miyazaki University1, Chubu University2

P-S8-01

Outreach Activities for Tobacco-Free Carried Out by Nursing Students
Risa NAKAYAMA1, Hitomi YAMAZAWA1, Naomi MIKAMOTO1, Yurie ONO1, Siori KURAMOTO1,
Chizuru OKAMOTO1, Kaoru INOUE4, Shinji ISHIKAWA2, Atsuko AOKI3, Masako SHIGETA1
Kyoto Prefectual University1, Kyoto First Red Cross Hospital2, Kyoto Association for Tabacco Control3,
Kyoto Tachibana University4P-S8-02

Effect on Doctor’s Knowledge, Attitude, and Practice of Tobacco Control of Creating Smoke-free
Hospital in 60 Hospitals in Beijing, Shanghai and Guangzhou of China
Na ZHAO
Chinese Association on Tobacco Control

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P-S8-03

The Tobacco Control Team in a Core Hospital and Citizens Join Forces to Take Up the Challenge
Against Tobacco in Omihachiman, Japan
Yohei HOSOKAWA1,3, Hiromi MORI1,3, Ikuko TANAKA1,3, Rumiko TERADA1,3, Yukiko NAKAGAWA1,3,
Kiyomi NISHII1,3, Satoshi TANABE1,3, Hatsumi KATAYAMA1,3, Kaoru INOUE2,3, Atsuko AOKI3,
Masako SHIGETA3,4
Omihachiman Community Medical Center1, Kyoto Tachibana University2, Kyoto Association for Tobacco
Control3, Kyoto Prefectural University of Medicine4P-S8-04

Changes in Behavior and Perception Regarding Smoking among Japanese Nursing Students from2003 to 2009~
Atsuko NAKAZAWA1, Masako SHIGETA2, Naomi MIKAMOTO2, Atsuko AOKI3,
Yoshiyuki WATANABE2, Kotaro OZASA6, Kaoru INOUE4, Takako MOURI2, Naoko MATSUMOTO5
Doshisha University Health center1, Kyoto Prefectural University of Medicine2, Heian Girls University3,
Tachibana University4, Radiation Effects Research Foundation5, Kyoto Nurcing Association6

P-S8-05

The Impact of Brief Smoking Cessation Counselling in a Tertiary Acute Care Hospital
Shu Yi LEE, Nora SAID, Kay Choong SEE
National University Hospital

P-S8-06

Tobacco Counselling Practices by Primary Care Providers: Perspectives of Patients
Rajmohan PANDA, Divya PERSAI
Public Health Foundation of India

P-S8-07

Advices of Quitting Smoking Are Necessary on Health Check-up.
Nobuhito ISHIKAWA1, Miyako TAKADA1, Katsura YAMAKADO2, Tokiko INOUE1, Miho UEDA1,
Junpei TAKAAKI1, Daisuke MATSUI3, Sayuki TORII4, Atsuko NAKAZAWA5, Masako SHIGETA3
Kyoto First Red Cross Hospital1, Kyoto Association for Tobacco Control2, Kyoto Prefectural University3,
Siga University4, Doshisya University5

P-S8-08

Smoking Prevalence and Factors among Nursing Students in Kyoto, Japan
Naomi MIKAMOTO1, Masako SHIGETA1, Atsuko NAKAZAWA3, Naoko MATSUMOTO4,
Takako MOURI2, Daisuke MATSUI2, Isao WATANABE1, Etsuko OZAKI1, Nagato KURIYAMA1,
Yoshiyuki WATANABE1
Kyoto Prefectual University of Medicine1, Kyoto Nursing Association2, Doshisya University3

P-S8-09

Smoking Cessation Services among Thai Community Health Nurses
Surintorn KALAMPAKORN1,2, Supanee SENADISAI2,3
Mahidol University1, Nurses' Network for Tobacco Control of Thailand2, Thailand Nursing and Midwifery
Council3

P-S8-10The Effectiveness of a Clinical Nurse Coordinator in Managing a Smoking Cessation Clinic in a
Private International HospitalThanida KHONGSAMAI, Kanjanee RUKSAKUN
Bumrungrad International Hospital

P-S8-11

Thai Nurses and Tobacco Control : Sharing Experiences
Orasa PANPAKDEE1, Supani SENADISAI2
Ramathibodi Hospital, Mahidol university1, The Nurses Network on Tobacco Control of Thailand2

P-S8-12

Health Systems Model for the Promotion of Smoke-Free Homes
Florante E. TRINIDAD1, Cecilia B. SANTOS2World Health Organization Office1, Philippine League of Government and Private Midwives, Inc.2

P-S8-13

Roles of Thai Nurses in Tobacco Control
Supanee SENADISAI1, Surintorn KALAMPAKORN2
Thai Nursing Council1, Mahidol University2

P-S8-14

A Comparison Study on Physician Survey 2003 and 2010 in Yogyakarta, Indonesia: Do thePrimary Health Care Doctors Assess and Advice more on Smoking Habit?
Yayi S. PRABANDARI, Arika DEWI
Universitas Gadjah Mada

P-S8-15

National Survey on Smoke – Free Primary Care Centers in Thailand
Pongsri SRIMORAGOT
Mahidol University

P-S9-01

A “Tobacco Craving Index” is a Useful Indicator to Predict Success of Smoking Cessation in
Settings of Smoking Cessation Therapy
Hideo TANAKA1, Chie TANIGUCHI2, Isao OZE1, Hideo SAKA2
Aichi Cancer Center Research Institute1, National Hospital Organization Nagoya Medical Center2

P-S9-02

Factors Associated with Weight Gain in Japanese Smokers Who Received Smoking Cessation
Therapy
Chie TANIGUCHI1, Hideo TANAKA2, Syouko ANDOU1, Mihoko SUGISHITA1, Ayumi KOGURE1,
Isao OZE2, Hideo SAKA1
National Hospital Organization Nagoya Medical Center1, Aichi Cancer Center Research Institute2

P-S9-03

WERO: An Innovative Group Stop Smoking Competition Designed to Reduce High Smoking
Prevalence among Ethnic Minority and Low Socioeconomic Populations: Main Results
Marewa P. GLOVER1, Nathan J. COWIE1, Chris PATON1, Anette C. KIRA1, Warren MOETARA2
University of Auckland1, Northland District Health Board2

P-S9-04

A Trial of Smoking Cessation Support for Youth Smokers in School Setting
Atsuko AOKI1, Naomi MIKAMOTO2, Nobuhito ISHIKAWA3, Kaoru INOUE4,
Takashi DOI1, Daisuke MATSUI3, Isao WATANABE2, Nagato KURIYAMA2, Masako SHIGETA2,
Yoshiyuki WATANABE2
Kyoto Association for Tabacco Control1, Kyoto Prefectual University of Medicine2, Japanese Red Cross
Kyoto Daiichi Hospital3, Kyoto Tachibana University4P-S9-05

Absence of Pre-operative Smoking Cessation is the Maximum Risk Factor of the Postoperative
Complications Occurrence
Masahiro MORI, Jun KOBAYASHI, Yuichi MORISHIMA, Yasuyoshi TOYODA, Daisuke SATOMI,
Yasuko TOSHIMITSU, Yoji TAKAMI, Satoshi FUKUTOMI, Kaisuke YAMAMOTO, Hiroshi KOMODA
National Hospital Organization Chiba medical center

P-S9-06

J-STOP (Japan Smoking Cessation Training Outreach Project): The Outline and Evaluation
Akira OSHIMA1, Shizuko MASUI2, Masakazu NAKAMURA2
Osaka Medical Center for Cancer and Cardiovascular Diseases1, Osaka Center for Cancer andCardiovascular Diseases Prevention2

P-S9-07

Factors Associated with Smoking Cessation among Bangladeshi Adults: Findings from ITC
Bangladesh Survey
Abu S. ABDULLAH1,2, Pete DRIEZEN3, Anne C. K. QUAH3, Nigar NARGIS4, Geoffrey T. FONG3,5
Boston University School of Medicine1, Guangxi Medical University2, University of Waterloo3, University of
Dhaka4, Ontario Institute for Cancer Research5

P-S9-08

The Way to Find “Hidden” Smokers’ Wish
Takahiro SHIMIZU1, Hiroshi YAMASHIRO1,2
Social Medical Corporation Keiaikai1, Okinawa University2

P-S9-09

Exercise Helps Smokers to Quit Smoking, to Remain Smoke-free and to Reduce the Risk of Death
Chi-Pang WEN, Wayne KAO, Min-Kuang TSAI, Shiuan Be WU
National Health Research Institutes, China Medical University Hospital, GLOBALink

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P-S9-10Enhancing Dental Tobacco Intervention under the Universal Health Insurance System in Japan
Takashi HANIOKA1, Miki OJIMA2
Fukuoka Dental College1, Osaka University2

P-S9-11

Capacity Building in Smoking Cessation – Singapore’s Experience
Sarita DEVI, Sultana Abdul LATIFF, Amrita NAMASIVAYAM, Chang Yin WUAN, Chris CHEAH,
Annie LING
Health Promotion Board

P-S9-12

Readiness to Quit Smoking among People Living with HIV/AIDS (PLWHA) in the Kathmandu
Valley, Nepal: Knowledge of Tobacco-related Health Risks is not Enough
Rachel M. AMIYA1, Krishna C. POUDEL2, Kalpana POUDEL-TANDUKAR3, Jun KOBAYASHI4,
Basu D. PANDEY5, Sushil KHATRI6, Masamine JIMBA1The University of Tokyo1, University of Massachusetts Amherst2, Waseda University3, Bureau ofInternational Cooperation4, Sukraraj Tropical and Infectious Disease Hospital5, Youth Vision6

P-S9-13

Varenicline Versus Transdermal Nicotine Patch : A 3-year Follow up in Smoking Cessation Clinic in
TaiwanKuang-Chieh HSUEH, Ming-Yueh CHOU, Lee-Fei PAN, Ming-Shium TU
John Tung Foundation

P-S9-14

Current Smoking Rate in Patients with Psychiatric Disorders in Japan: Questionnaire Survey
Wakako NAKANO1, Kenji HAYASHI1, Chiharu YOSHII2, Jun NAKAMURA1
University of Occupational and Environmental Health1, Wakamatsu Hospital of University of Occupational
and Environmental Health2

P-S9-15

Outcome of Smoking Cessation Therapy for Nicotine Dependents with Psychiatric Disorders inJapan
Wakako NAKANO1, Kenji HAYASHI1, Chiharu YOSHII2, Jun NAKAMURA1
University of Occupational and Environmental Health1, Wakamatsu Hospital of the University ofOccupational and Environmental Health2

P-S9-16

Evaluation of One-year Outcome of Smoking Cessation among Patients who Successfully
Finished a 12-week Smoking Cessation Program
Chiharu YOSHII1, Fumio KUNITOMO2, Masato KANO3, Chinatsu NISHIDA4, Yukiko KAWANAMI4,
Hiroshi MUKAE4
Wakamatsu Hospital of University of Occupational and Environmental Health1, Chiba Rosai Hospital2, Shinnakagawa Hospital3, University of Occupational and Environmental Health4

P-S9-17

New Zealand’s Tobacco Control Research Tūranga: Accelerating Progress towards Smokefree
New Zealand by 2025
Marewa P GLOVER, Chris R BULLEN
University of Auckland

P-S9-18

Smoking Cessation Outcomes among Individuals with a History of Psychotic Disorders as
Compared to Those Without
Chizimuzo T. C. OKOLI1, Milan KHARA2
University of Kentucky1, Vancouver Coastal Health Mental Health and Addictions Services2

P-S9-19

Efficacy of Foot Reflexology on Tobacco Cessation in Smart Quit Clinics; Multicenter.,Thailand
Amporn KROBTHONG, Thanut DOLAMPORNPHISUTH, Tippawan TEERASIRIROJ
Thai Health Professional Alliance Against Tobacco

P-S9-20

Web-Based Diet Management Program for Smoking Cessation: Content and Web Development
Faizah SAFINA, Zarina RAMLY
Universiti Malaya

P-S9-21

Cessation Support via Mobile Phone Text Messaging: Results from a Pilot Program in Suzhou,
China
Pamela B. REDMON1, Erik M. AUGUSTSON2, Yixin DUAN1, Yaodong PAN3, Hanchang GAO3
Emory Global Health Institute1, National Cancer Institute2, Suzhou CDC Health Education Institute3

P-S9-22

Smoking Cessation Treatment Outcomes in Men and Women in Taiwan: Implications forInterpreting Gender Differences in Smoking Cessation with Nicotine Patch
Kuang-Chieh HSUEH1,2,3,*, Shu-Chun HSUEH4, Ming-Yueh CHOU1, Ming-Shium TU1,
McRobbie HYDEN3, West OLIVER3, Peter HAJEK3
Kaohsiung Veterans General, Hospital1, Shu-Zen College of Medicine and Management2, University of
London Turner Street3, Meiho University4P-S9-23

Effects of Acupressure on Chinese Traditional Acupoints on Smoking Cessation
Thaniya KLINSOPHON, Premtip THAVEERATITHAM, Prawit JANWANTANAKUL
Chulalongkorn University

P-S9-24

Smoking Cessation Guide Books in Meiji Era Japan (1868-1912)
Hiroshi KAWANE, Sayuri WATANABE, Naoko TAKESHITA
Japanese Red Cross Hiroshima College of Nursing

P-S9-25

Socio-economic Status of Patients in Cessation Outpatient Department of General Hospitals
Kaoru INOUE1,2,3
Kyoto Tachibana University1, Kyoto Prefectural University of Medicine2, Kyoto Association for Tobacco
Control3

P-S9-26

Smoking Cessation of Mentally-Disabled Persons: An Appication of Transtheoretical Model
KIe CHIDA1, Yoshikatsu MOCHIZUKI 2Urakawa Public Health Center of Hokkaido Government1, Asahikawa Medical University2

P-S9-27

The Effectiveness of Outpatient and Inpatient Smoking Cessation Programmes at Khoo Teck Puat
Hospital: Is There Any Difference?
Pei C. YONG, Su F. OH
Khoo Teck Puat Hospital

P-S9-28

Factors Affecting Motivation to Tobacco Cessation: Experiences from India
Rajmohan PANDA, Divya PERSAI
Public Health Foundation of India

P-S9-29

The Importance of the Consultation Times to Make High Success Ratio of Smoking Cessationfrom the Analysis of Patient’S Background, to Make Better Clinical Pathway
Akari OIKAWA, Misato TAKAHASHI, Mayumi TAKAHASHI, Haruna SAITOU, Rumi TAKAHASHI,
Chikako HIBINO, Kayoko ABE, Misato OBARA, Hiroshi TAMURA
Hiroshi Tamura's Hill-Top Clinic

P-S9-30

The Influence of Strict Implementation of Safety Warning of Varenicline Concerning about Driving
Motor Vehicle on a Tobacco Cessation Clinic in Japan
Iwao GOHMA, Hiromi TAKAHATA, Yuko ASAI, Miyuki TSUTSUMI, Atsumi MATSUBAYASHI,
Asuka KOKAWA
Tobacco Cessation Clinic at Sakai City Hospital

P-S9-31

Inpatient Smoking Cessation Program: Effect of Intensive Counseling Combined with Telephone
Follow-up in South Korea
Sun-Hee KIM, Jung-Ah LEE, Hong-Jun CHO
University Ulsan Medical College

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P-S9-32

Motivational Interviewing to Enhance Nicotine Patch Treatment for Smoking Cessation among
Homeless Smokers: A Randomized Controlled Trial
Kolawole S. OKUYEMI, Kate GOLDADE, Janet L. THOMAS, Sara EISCHEN, Barrett SEWALI,
Hongfei GUO, John E. CONNETT, Jasjit S. AHLUWALIA, Ken RESNICOW, Lillian GELBERG
University of Minnesota Academic Health Center1, University of Michigan School of Public Health2,
University of California Los Angeles3

P-S9-33

Smoking Cessation with Psychiatric Outpatients at a Private Psychiatric Hospital in Japan
Masami SATO
Tokyo Musashino Hospital

P-S9-34

Predictors for Successful Smoking Cessation and Its MaintenanceAyako OKUNO1, Midori YAMANA1, Naohiko FUJII1, Hiroyuki NARAHARA1, Yoshihiro CHIMORI2
Hyogo Prefectural Nishinomiya Hospital1, Kawanishi City Hospital2

P-S9-35

Evaluation of Social Nicotine Dependence Using the Kano Test for Social Nicotine Dependence(KTSND-K) Questionnaire in Patients with Lung Cancer
ChulHo OAK1, TaeWon JANG1, MaanHong JUNG1, EunKee PARK1, Chiharu YOSHII2
Kosin University College of Medicine1, Wakamatsu Hospital of University of Occupational andEnvironmental Health2

P-S9-36

Psychometric Testing of the Chinese Version of the Cigarette Withdrawal Scale in Taiwanese Male
Smokers
Chih-Ling HUANG1, Hui-Wen HUANG2, Kuang-Chieh HSUEH3
Chang Jung Christian University1, Chi Mei Medical Center2, Kaohsiung Veterans General Hospital3P-S9-37

Lessons Learned about Smoking and Relapse Following the Christchurch Earthquakes
Vivien A. DALEY
Cantabury District Health Board

P-S9-38

Psychological Characteristics in Patients during Treatment of Tobacco Dependence
Akiko MATSUDA1, Junichi HASEGAWA2, Xinhui WANG2, Satoshi TSUNO2, Norimasa MIURA2
Tottori University

P-S9-39

Patterns of Posting Behaviour in an Online Cessation Community
Benjamin HEALEY, Janet HOEK
University of Otago

P-S9-40

Socio-economic Status of Patients in Cessation Outpatient Department of General Hospitals
Kaoru INOUE
Kyoto Tachibana University

P-S9-41

Paradise Lost: A Hypothetical Theory of Nicotine Dependence
Takeshi ISOMURA
Reset Behavior Research GroupP-S10-01

Is Urinary Cotinine Level of Children Useful to Predict Whether Their Parents will Quit Smoking inFuture?
Kazuo KUROSAWA1, Toshihiro INO1,2
Ino Clinic1, Gunma Paz College2

P-S10-02

An Analysis on the Smoking Related Psychological Factors and Socioeconomic Status in 1006
Smokers
Xiao-nong ZOU1, Zhen DAI2, Yuan-li CHEN2, Gong-bo CHEN2, HuanFeng FENG2, Ping ZHAO2National Office for Cancer Prevention and Control, Cancer Institute/Hospital1, Peking Union Medical
College2

P-S10-03“Towards a Tobacco-free Companies Healthy and Happy Living for All Workshops ThroughCorporate Social Responsibility”
Vijay B. YETAPU
VChangeU

P-S10-04

Reported Exposures to Anti-smoking Messages and Their Impact on Chinese Smokers’
Subsequent Quit Attempts
Lin LI1, Ron BORLAND1, Hua-Hie YONG1, Geoffrey T. FONG2,3, Yuan JIANG4, Qiang LI4,David HAMMOND2, Anne C. K. QUAH2Cancer Council Victoria1, University of Waterloo2, Ontario Institute for Cancer Research3, Chinese Center
for Disease Control and Prevention4

P-S10-05

Teacher Tool Kit for Smoke Free School : Produce of Knowledge Management of Teachers
Network, Thailand
Anong PUATRAKUL, Suwimon CHANPREMPRUNG, Thawatchai KOBOON
ThaiHealth Promotion Foundation

P-S10-06

Beliefs about “High Grade” Cigarettes among Smokers in Seven Cities in China: Findings from the
ITC China Survey
Qiang LI1,2, Geoffrey T. FONG2,3, Anne C. K. QUAH2, Yuan JIANG1, Changbao WU2Chinese Center for Disease Control & Prevention1, University of Waterloo2, Ontario Institute for Cancer
Research3

P-S10-07

Self-Exempting Beliefs about Smoking in Predicting the Plan and the Success of Quitting in the
Next Wave: Findings from the ITC Korea Survey
Eon Sook LEE1, Jun Hyung LEE1, Hong Gwan SEO2, Yeol KIM2, Anne C. K. QUAH3, Geoffrey T. FONG3
Ilsan Paik Hospital1, National Cancer Center2, Department of Psychology, University of Waterloo3, Ontario
Institute for Cancer Research4

P-S10-08

Spread of Tobacco Free Campus in Japanese Universities
Masayuki TAKAHASHI, Takashi NISHIMOTO, Tomoya MURAKAMI
Biwako Seikei Sport College

P-S10-09"Manga"-based Quitting Smoking Campaign in Health Insurance Society A
Tomomi NAGASHIMA1, Takeshi ISOMURA2
Nisseikyo Health Insurance Society, Research Group on Smoke-free Psychology1, Reset Behavior ResearchGroup, Research Group on Smoke-free Psychology2

P-S10-10

Effectiveness of Clinical Pathway for Tobacco Cessation Program
Yoko KAIDO1, Natsuko SATO1, Maki SUZUKI1, Sayori MIYANO1, Ekuko SENO1, Yumi ONO1,
Satsuki YONEUCHIYAMA2, Etsuko TANAKA2, Masayuki SAKURAI2, Ichiro SAKUMA1
Caress Sapporo Hokko Memorial Clinic1, Caress Sapporo Hokko Memorial Hospital2

P-S10-11

Association between Smoking Behavior, the Smoking Status of Their Parents and Friends and
Own Self-denial Image among University Students in Tokyo, Japan
Izumi SEZAI1, Tsunetsugu MUNAKATA2
Musashi University1, Institute of Health Behavioral Science2

P-S10-12

Japanese Smoking Problems Which Became Clear from Interviews with Participants of the APACT
2010 Held in Sydney
Toshiharu ETO, Keiko AOISHI
Miyazaki University

P-S10-13

What Messages Do Young Adult Smokers Believe will be Effective in Cessation Advertising?
Ninya MAUBACH, Janet HOEKASPIRE2025

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P-S10-14

Tobacco Control-Why & How
Dilip K. ACHARYA
Cancer Society of Madhya Pradesh, GB Pant District Hospital, Indian Medical Association-Indore

P-S10-15

How to Build and Operate a High Traffic Website -Using the JTF Official Website - E-Quit Chinese
as an Example
Ching-Li LIN, Tzu-I LU, Jen-Huan HUJohn Tung Foundation

P-S10-16

What Effects of Smoking Ban in Indoor Public Places has on Smokers’ Perception, Their Attitudeof Smoking around Children and Implementation of Smoke-Free in Their Homes and Private
Vehicles?: Findings from Intercept Study of Smoke- Free Melaka City (SFMC) Policy
Noraryana HASSAN1 ,Maizurah OMAR2, Rahmat AWANG1,3, Yahya BABA3, Nur Hanani JASNI2,
Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH3, Pete DRIEZEN3, Mary THOMPSON3,
Geoffrey T FONG3
Melaka State Health Departments1, Universiti Sains Malaysia2, Malaysian Health Promotion Board3,
University of Waterloo4

P-S10-17

Location of Smoking at Home, Asthma Control and Lung Function in School Children
Shuichi SUZUKI, Hiroko WATANABE, Yoko NEZU, Kazuki SATO, Toshiyuki NISHIMUTA
Department of Pediatrics, Shimoshizu National Hospital

P-S10-18

A Study on Effectiveness of School Tobacco Control Program in Myanmar
Aung TUN, Su M. MYAT, Phyu T. HAN, Thuya AUNG
Ministry of Health

P-S10-19

Usefulness of a Brief Street Campaign to Promote Smoking Cessation by Using Premiums andVideosHiroyasu MURAMATSU
Central Medical Clinic

P-S10-20

Trend of Tobacco Use & Cessation Training among Third-year Medical Students in Thailand Using
Data from the Global Health Professions Student Surveys (GHPSS)
Suthat RUNGRUANGHIRANYA, Chatchai EKPANYASKUL
Srinakharinwirot University

P-S10-21

Impact of Major Floods on Smoking Behavior and Nicotine Dependence
Suthat RUNGRUANGHIRANYA, Suthee RATTANAMONGKOLGUL
Srinakharinwirot University

P-S10-22

Building Tobacco Control Capacity at the Village Level in India
Rajashree S. KADAM, Devika M. CHADHA, Jayshali B. TAMBE
Salaam Bombay Foundation

P-S10-23

Smoking in the Seas: Tackling Smoking Prevalence among Navy Recruits
Khartika M. SHARIF, Vasuki UTRAVATHY, Vijayalakshimi KARUPPIAH
Health Promotion Board

P-S10-24

Parental Advisory Program: The Effort to Reduce Smoking Behavior at Home
Walidatul L. MARDLIYAH, Mochamad I. NURMANSYAH
State Islamic University Syarif Hidayatullah of Jakarta

P-S10-25

Smoking-Related Cognition, Secondhand Smoke Exposure, the Awareness of Smoking and the
Effects of Anti-Smoking Education for Fifth and Sixth Grade Elementary School Children
Koji INAGAKI1,6,15,16, Hidehiko KAMEI1, Toshihide NOGUCHI1, Ichizo MORITA1, Shigeharu IEDA1,13,
Takeshi ISOMURA3,6,12,13,16, Kimiko UOZUMI4,13, Isao OHSAWA5,16, Chie TANIGUCHI5,12,13,
Yukinobu YAMAGUCHI6,13, Masako KITADA7,13, Akira ENDO8,13, Tetsuya OTANI9,13, Chiharu YOSHII10,13,
Masato KANO11,13
Aichi-Gakuin University1, Chukyo University2, Reset Behavioral Research Group3, Omoteyama Clinic4,
Nagoya Medical Center5, Network for adolescence6, Sapporo Gakuin University7, Endo Children Clinic8,
National Research Institute9, University of Occupational and Environmental Health10, Shin-nakagawa
Hospital11, KTSND12, Aichi Association for Tobacco-free Kids13

P-S10-26

The Association Between Second-hand Smoke Exposure, Knowledge and Willingness to Perform
Smoke-free Rights of Non-smokers in Guangzhou
Yi YANG, Kai-liang CHENG, Jun LIU, Xiao-hua YE, Lei CHEN
Guangdong Pharmaceutical University

P-S10-27

Smoke, Smoking and Cessation: The Views of Children with Respiratory Illness
Marewa GLOVER, Anette KIRA, Julienne FALETAU
University of Auckland

P-S10-28

Outreach Activities for Tobacco-Free Carried out by Medical Students
Urara SAITO, Kotaro TAKEBE, Tatsuro OAKU, Yosuke TARUMI, Akira SAKAMOTO, Shinji TOMOTA,
Takatoshi FUJITO, Hirofumi SUZUKI, Yuriko KONDO, Masako SHIGETA
Kyoyo Prefectual University of Medicine

P-S10-29

The Relationship between Tobacco-Control Status and Smoking Behavior Among Students at 81
National Universities in Japan
Kitada MASAKO1, Musashi MANABU2,4, Yoshino KEIKO3,4
Sapporo Gakuin University1, Hokkaido University2, Utsunomiya University3, Japanese National University
Council of Health Administration Facilities4

P-S10-30

Challenges in and Measures against Workplace Smoking in Yamagata Prefecture’s Administrative
Offices
Atsuko KAWAI1,2, Yoko MATSUNAMI1,3
Nanyou&Higashi Okitama Medical Association1, Social Medical Corporation2, Yamagata University3

P-S10-31

School-level and County-level Factors Associated with Smoking among Middle School Students
Song-Lih HUANG, Yu-Yun HUNG, I-Fen LIN
National Yang Ming University

P-S10-32

Four Years of National Tobacco Control Programme in India: a Critical Review
Ravinder KUMAR, Pranay LAL, Rana J. SINGH
Tobacco control

P-S10-33

Ensuring Tobacco Control Law Implementation through GO-NGO Capacity Building
Ishrat CHOWDHURY
International Union Against Tuberculosis and Lung Disease

P-S10-34

Kameoka City, Kyoto, Japan Takes Up the Challenge for Making Smoke-free City with Strategies
and Persistence
Masako SHIGETA1,2, Mika YAMASHITA1, Hiroko TOYOSHIMA1, Shohei YOKOTA1, Atsuko AOKI2,
Takashi DOI2, Chiaki SAKAI3, Kumiko OHNO4, Noriko IJIRI4, Tomoko OHTA4
Health Center of Nantan district1, Kyoto Association for Tobacco Control2, Sakai Dental Clinic3, Kameoka
City4

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P-S10-35

Implementation of Tobacco Control for Rural Communities by Primary-Care Units or Health
Promotion Hospitals of Sub-district Level in Thailand
Chanthana VITAVASIRI, S. PAUSAWADI
Commmittee and President of Thai Health Professional Alliance Against Tobacco

P-S10-36

Predictors of Smoking Behavior among Female Students of High Schools and Vocational
Education Colleges in North-Eastern Thailand
Ratchanee VEERASUKSAWATT, Nuanjan PRAKENREE, Wanpen DUAGMALA,
Wantanee THONGNUN, Parichat JAISUPAP, Pougthong TRYCHASIRIKOSOL
Sanpasithiprasong Hospital

P-S10-37

Study of the Smoking Preventive Education in the Teacher Training
Hiroko ISODA
Sonoda women’s University

P-S10-38

Changes in Perceptions on the Effectiveness of Tobacco Control Policies among Adolescents: A
Prospective Study
Melinda PENZES, Robert URBAN, Peter BALAZS, Kristie Long FOLEY
Smmelweis University

P-S10-39“Tobacco Free Teacher, Tobacco Free Society” – Empowering Teachers in Rural India to Raise
Awareness and Advocate for Enforcement of Tobacco Control Law
Jayshali B. TAMBE, Devika M. CHADHA, Deepak PATIL, Rajashree S. KADAM
Salaam Bombay Foundation

P-S10-40

Expanding the Tobacco Control Health Network: A Hospital, School, and Police Station Project
Krongjit VATHESATOGKITThai Health Promotion Foundation

P-S10-41

Community Tobacco Cessation in Mumbai
Ajay PILANKAR, Devika CHADHA, Tshering BHUTIA
Salaam Bombay Foundation

P-S10-42

Using Indian Festivals to Advocate for Tobacco Control: Innovative Ways to Reach Out toCommunities and Stakeholders
Tshering BHUTIA, Devika CHADHA, Narayan LAD
Salaam Bombay Foundation

P-S10-43

Changes of Tobacco Use Behaviors in Thai Dental Students in 5 years
Wikul VISALSETH1, Surat MONGKOLNCHAIARUNYA1, Thongchai VACHIRAROJPISAN2Ministry of Public Health1, Chulalongkorn University2

P-S10-44

Survey of Pharmacists about Tobacco
Takuya SHIDARA1, Tatsuhiro KOMOTO1, Yuji SAKURABA1, Emi KISARA2, Keiko KAWASHIMA1,
Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2

P-S10-45

Smoke Free Campus on Active Participation of Student Forum- SHUBASH at Southwestern Partof the Bangladesh
Md Aminul I. BAKUL, Ishrat C. ISHRAT, Abdur R. RAZZAKThe Union South East Asia

P-S10-46

Prevalence and Determinant of Illicit Cigarette Consumption in East and Central Java Province,
Indonesia1
Nur Hadi WIYONO1, Ayke Soraya KITING1, Elda L. PARDEDE1, Abdillah AHSAN1, JM. BOWLING2,
K. FOONG3
University of Indonesia1, University of North Carolina2, University Sains Malaysia3

P-S10-47

Exposure to Secondhand Smoke and Its Relationship with Academic Performances and Cognitive
Abilities among Primary School Children in Serdang
Emilia ZAINAL ABIDIN, KHAIRUNISA SALIMAN
Universiti Putra Malaysia

P-S10-48

Quit and Win 2012
Kong MOM1, Yibee HUANG2
Cambodia Movement for Health1, Taiwan International Medical Alliance2

P-S10-49

Perception of Second Hand Smoker and Support Toward Smoke Free Area Among Public in Kota
Bharu, Kelantan
Harmy MOHAMED YOSOFF1, Aisyah Aliana MOHD ZABIT2, Siti Syafiqah SUHAIMI2,
Nurul MOHAMED2
School of Medical1 Sciences, Malaysia2

P-S10-51

What is Needed to Achieve New Zealand’s Smokefree Nation Goal: Results from a Forecasting
Model
Takayoshi IKEDA1, Linda COBIAC1,2, Nhung NGHIEM1, Kristie CARTER1, Nick WILSON1,
Tony BLAKELY1
University of Otago1, University of Queensland2

P-S10-52

Tobacco Control Basic Training in Taiwan-the Health Care Professionals Trainees’s Knowledge,
Attitudes and Barriers
Pei Wen TIEN
Taiwan Nurses Association

P-S10-53

Quit & Win Campaign 2012 Promotional Strategy—Social Smoking Cessation Carnival
Atmosphere Encouraged Over 30,000 Participants to Quit Smoking
Shu-Li CHEN, Ching-Li LIN, Ying-Chun CHEN, Tzu-I LU, Jen-Huan HUJohn Tung Foundation

P-S10-54

Using Intervention Mapping to Describe the Development of the Malaysian Advisor’s Smoking
Cessation Website
Omar S. ATTIYAH, Faizah SAFINA
Universiti Malaya

P-S10-55

Present Status and Problems of Non Smoking Activities in Rural Areas--- Through the Activities of the Board of Studies Smoking Yamagata
Shuichi OTAKE
Yamagata Smokefree NPO corporation

P-S10-56

How to Make the Masses do Effective Tobacco-free Actions
Takahiro SUZUKI1, Atsuko KAWAI2
Office worker1, Kotokukai Total Health Clinic2

P-S10-57

Tobacco Free * Japan TV - an Innovative Platform to Drive Tobacco Free Policies in Japan
Yumiko MOCHIZUKI
National Cancer Center

P-S10-58

Effects of a Cigarette Smoking Prevention Program among Junior High School Pupils in NorthEast Thailand: A Pilot Survey
Anun CHAIKOOLVATANA B.1, Mereerat MANWONG1, Niyom JUNNUAL1,
Cholada CHAIKOOLVATANA2, Wantanee THONGNUN3, Jamsai APIRAKMONTREE4,
Areepan WANCHAI5, Maleewan PONGPAEW5
Ubon Ratchathani University1, University of Phayao2, Sapasithiprasong Hospital3, Pratumpithayakom
School4, Sripratumpithayakarn School5

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P-S10-59

School Tour for “Smoke Free Homes Campaign” Project
Chawala PAWAPUTANONT1, Sangduean SUWANRATSAMEE2
Action on smoking and Health foundation1, ThaiHealth Promotion Foundation2

P-S10-60

Tobacco Control Advocacy with the Indian Film Fraternity
Blesson THOMAS, Tshering BHUTIA, Devika CHADHA
Salaam Bombay Foundation

P-S10-61

SMART Journal for Tobacco Control Project
Suksan SELANON
Action on Smorking and Health Foundation

P-S10-62

Survey of Care Workers about Tobacco
Yuji SAKURABA1, Tatsuhiro KOMOTO1, Takuya SHIDARA1, Emi KISARA2, Keiko KAWASHIMA1,
Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2

P-S10-63

Adolescent’s Knowledge and Opinion on Cigarette Smoking : Findings from - ITC – SEA (Thailand)
SurveyTawima SIRIRASSAMEE1, Buppha SIRIRASSAMEE2, Aree JAMPAKLAY2, Ron BORLAND3,
Geoffrey T. FONG4, David HAMMOND4
Srinakharinwirot University1, Institute for Population and Social Research2, The Cancer Council Victoria3,
University of Waterloo4

P-S10-64

Survey of Knowledge and Attitudes toward Cigarette Consumption among Young Primary School
Pupils, Ubon Ratchathani
Niyom JUNNUAL1, Anun CHAIKOOLVATANA2, Soontorn SERASART2, Preeyaporn PHARUENG2
College of Medicine and Public Health1, Faculty of Phamacy2

P-S10-65

Psychological and Social Determinant of Smoker; Street Children at Depok City, Indonesia
Mochamad A. RUSLIALDI, Tania KHAERUNNISA
University of Indonesia

P-S10-66

Awareness Survey of Individuals Who Actually Quit Smoking
Shigeto TAKAGI, Masataka SHOUDA
Semen's Insurance Health Care and Reserch Center

P-S10-67

Using Social Media to Monitor and Counter the Tobacco Industry (TI): The ASEAN Experience
Mary Jocelyn F. ALAMPAYSoutheast Asia Tobacco Control Alliance

P-S10-68

The Current State of Smoking Cessation Support Provided by Smoking Cessation Treatment
Nursing Staff, Their Sense of Humor and Communication Skills, and the Relevance of Humor andCommunication in Job Satisfaction and SuccessNaoko YANO
Japanese Red Cross Medical Center

P-S10-69

A Team Approach for Raising the Quit Smoking Rate at a Primary Care Clinic in Japan
Masataka KATO, Akemi NOMURA, Yoko MIYAKE, Natsumi NAKAGAWA, Mai TANAKA
Kato Clinic

P-S10-70

Stop Smoking through Fasting in Ramadan: The Unassisted Smoking Cessation Approach to
Reducing Smoking Rates (The Case of Banda Aceh-Indonesia)
Rizanna ROSEMARY1, Fanny NAILUFAR2
Syiah Kuala University1, Universitas Serambi Mekkah2

P-S10-71

Buddhist Monk Doctor Blows the Whistle on Marketing a "Cigarette-like Incense Stick” Which
Violates FCTC Art.16.1(c)Akinori KURUMA
Kouganji Temple, The Japan Society for Tobacco Control

P-S10-72

Overview of the Tobacco Control Coverage’ Communication Model in China
Jun SONG, Xuezheng JIN, Xiaobei LI
Chinese Center for Health Education

P-S10-73

Smoke Free Tribal Districts: Results of a Sub National Compliance Survey in Himachal Pradesh,
India
Ravinder KUMAR1, Pranay LAL1, Rana J. SINGH1, Salig R. MAZTA2, Narender SHARMA3
The Union South East Asia1, IGMC Shimla2, HPVHA Shimla3

P-S10-74

Effectively of Health Warnings on Tobacco Product Packaging to Reduce amount of SmokerStudents in Depok, West Java
Wilda Af’idah BITARI, Evi NURHIDAYATI
University of Indonesia

P-S10-75

Practical Tips for Maintaining a Strong Alliance
Saifuddin AHMED
Bangladesh Anti Tobacco Alliance

P-S10-76

How to Enlighten Both Smokers and Non-Smokers Who Have No Interest in Tobacco Problems Through Our Experience to Manage One of The Largest Local World No Tobacco Day Events inJapan Masataka KATO, Katsuhide OHASHI, Katsushi MURAYAMA, Akemi NOMURA, Yoko MIYAKE,
Natsumi NAKAGAWA, Mai TANAKA, Harumi MURAYAMA, Yoshiko WATANABE
Tobacco Free Ehime

P-S10-77

Play the Role of Non-governmental Organizations, Fight against Tobacco Industry Interferencewith Tobacco Control
Guihua XU, Chao SUO
Chinese Association on Tobacco Control

P-S10-78

Non Aired Mass Media Tobacco Control Methods
Dilip K. ACHARYA1,2,3
Cancer Society of Madhya Pradesh1, GB Pant District Hospital2, Indian Medical Association-Indore3

P-S11-01

The Impact of Tax Structure on Cigarette Prices: Findings from the ITC Project
Ce SHANG1, Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Mary THOMPSON2, Richard J O’CONNOR4
University of Illinois1, University of Waterloo2, Ontario Institute for Cancer Research3, Roswell Park Cancer
Institute4

P-S11-02

Factors Associated with Expected Tobacco Price Increase Needed for Quit Attempt: Findings fromthe ITC Korea Survey
Sung-il CHO1, Susan PARK1, Eunja PARK2, Yeol KIM3, Hong-Gwan SEO3, Pete DRIEZEN4,
Anne C.K. QUAH5, Geoffrey T FONG4,5
Seoul National University1, Korea Institute of Health and Social Affairs2, National Cancer Center3,
University of Waterloo4, Ontario Institute for Cancer Research5

P-S11-03

Analysis of Correlation Between Smokers’ Income and Their Budget Allocation of Buying
Cigarettes
Nurul M. RAHMAYANTI, Nurani P. EKAPUTRI, Muhammad KHAIRI
University of Indonesia

63

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P-S11-04

Pesticide Use in Thailand’s Burley Production: Health Costs Should be Realized
Jirawat JAROENSATHAPORNKUL
Srinakharinwirot University

P-S12-01

Electronic Cigarettes Using Status and Relating Factors among Korean Adult Smokers: Findings
from the International Tobacco Control (ITC) Korea Survey
Yeol KIM1, Hong Gwan SEO1, Mi YAN2, Sang Mi KWAK3, Hyun-Suk JUNG3, Anne C.K. QUAH2,
Geoffrey T. FONG2,4
National Cancer Center1, University of Waterloo2, Sungkyunkwan University3, Ontario Institute for Cancer
Research4

P-S12-02

The Potential of Tobacco (Nicotiana Tabacum) Extract and Methyl Eugenol as Green Organic
Insecticide
Erna FEBRIYANTI, Yoga PRIASTOMO, Anki Novairi DARI, Wiwin SRININGSIH, Jumina JUMIA
Universitas Gadjah

P-S13-01

Opinions of the Public and Tobacco Industry about the Ban on Sale of Gutkha and Paan Masala in
India
Devika CHADHA, Narayan LAD, Nishi ARORA
Salaam Bombay Foundation

P-S13-02

Retailer’s Behavior toward the Sale of Tobacco in a Community near a University in the Lower
Northern Thailand
Chakgarphan PHETPHOOM1, Piyarat NIMPITAKPONG2Naresuan University1, Naresuan University2

P-S13-03

Hypothesis: The Tobacco Plant (Nicotiana Tabacum) Will Be Pathogen of Infectious Disease
Satoshi HIROTA
Osaka City Health Center

P-S14-01

An Experience with Direct Marketing Strategy Using Mobile Phone by a Tobacco Industry in Japan
Masako SHIGETA1,2, Isao WATANABE1, Daisuke MATSUI1, Kaoru INOUE1, Nahomi MIKAMOTO1,
Atsuko AOKI2, Takashi DOI2, Narito KURIOKA2, Tadaaki MORI2, Yuji YASUDA2
Kyoto Prefectural University of Medicine1, Kyoto Association for Tobacco Control2

P-S14-02

Advertisement Ban Enforcement in Cambodia: Survey in Three Provinces
Yibee HUANG1,2, Kong MOM3, Daravuth YEL4, Song-lih HUANG1,2
Taiwan International Medical Alliance1, National Yang-Ming University2, Cambodia Movement for Health3,
WHO Cambodia4

P-S14-03

Mouth Freshener Serves Surrogate for Tobacco Products Advertisements in India?
Ravinder KUMAR1, Pranay LAL1, Rana J. SINGH1, Narender SHARMA2
Tobacco control1, Public health, HPVHA Shimla2

P-S14-04

KASH Surveys Seoul Retail Tobacco Advertising Trends
Eun Ji KIM, Hong Gwan SEO
Korean Association on Smoking or Health

P-S14-05

Delegitimizing Tobacco Industry Sponsorship of Primary Schools in China
Miranda WANG1, Yiqun WU
Campaign for Tobacco-Free Kids1, Thinktank Research Center for Health Development2, Chinese
Association on Tobacco Control3

P-S14-06

Curbing Surrogate Tobacco Advertisements at Public Transport Systems and during Festivals in
Mumbai
Tshering BHUTIA, Devika CHADHA, Narayan LAD, Rajashree KADAM
Salaam Bombay Foundation

P-S14-07

Denormalization of CSR Tobacco Industry in Thailand
Chulunee PICHAYAKUNMONGKOL
Thai Health Promotion Foundation

P-S14-08

Institutional Defects in the System of Evaluation and Monitoring of Tobacco Products in China
Quan GAN1, Gonghuan YANG2
International Union Against Tuberculosis and Lung Disease, Beijing1, Peking Union Medical College2

P-S14-09

David versus Goliath: Denormalizing CSR activities of the Tobacco Industry in the Philippines
Irene Patricia N. REYES1
HealthJusticeP-S15-01

Perceptions of Health Warning Labels for Smokeless Tobacco Packages in India and Bangladesh
Seema MUTTI1, David HAMMOND1, Jessica L. REID1, Prakash C. GUPTA2, Mangesh PEDNEKAR2,
Hemlata SHEDGE3, Nigar NARGIS3, AKM Ghulam HUSSAIN3
University of Waterloo1, Healis-Sekhsaria Institute for Public Health2, University of Dhaka3

P-S15-02

Plain Packaging on Intention not to Smoke among Thai Youths
Nithat SIRICHOTIRATANA, Chukiat VIWATWONGKASEM, Dusit SUJIRARAT,
Pratana SATITVIPAWEE, Naruemon AUEMANEEKUL, Malinee SOMPOPCHAROEN,
Pimpan SILPASUWAN
Mahidol University

P-S15-03

The Effectiveness of Health Warnings in China: Longitudinal Findings from the ITC China Survey
Geoffrey T. FONG1,2,3, Lin XIAO3, Yuan JIANG3, Qiang LI1,3, Pete DRIEZEN1, Lin LI4, Hua YONG4
University of Waterloo1, Ontario Institute for Cancer Research2, Chinese Center for Disease Prevention andControl3, The Cancer Council Victoria4

P-S15-04

Challenge in the Implementation of 75% Pack Warning: An Example of Tobacco Industry
Interference
Shanta L. MULMI
Resource Centre for Primary Health Care

P-S15-05

Wear-outs Effects on the Malaysian Pictorial Health Warnings: Findings from the International
Tobacco Control Policy Evaluation (ITC) Malaysia Project
Zarihah ZAIN1, Maizurah OMAR2, Rahmat AWANG2, Noor Afiza Abd. RANI2, Sazaroni Md. RASHID2,
M Nazri M. TAHIR2, Shalihin M SAMIN2, Anne C. K. QUAH3, Geoffrey T. FONG3,4, Ron BORLAND5
Malaysian Women’s Action for Tobacco Control & Health (MyWATCH)1, Universiti Sains Malaysia2,
University of Waterloo3, Ontario Institute for Cancer Research4, The Cancer Council Victoria5

P-S15-06

Prevalence and Predictors of Misperceptions About “Light” and “Low-Tar” Cigarettes: Findings
from the ITC Korea Survey
Annika C. GREEN1, Geoffrey T. FONG1, Tara ELTON-MARSHALL1, Hong Gwan SEO2, Yeol KIM2
University of Waterloo1, National Cancer Center2

P-S15-07

Inter-Rater Reliability Study of Pack Identification to Determine Illicit Cigarettes in 3 ASEANCountries
Kin FOONG 1, Yen Lian TAN2, James Michael BOWLING3, Anthony SO4
Universiti Sains Malaysia1, Southeast Asia Tobacco Control Alliance2, University of North Carolina3, Duke
University4

P-S15-08

Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in theContext of an Experimental Study in Four Asian Countries
Jessica L REID1, Seema MUTTI1, David HAMMOND1, Prakash GUPTA2, Qiang LI3, Jiang YUAN3,
Nigar NARGIS4
University of Waterloo1, Healis-Sekhsaria Institute for Public Health2, Chinese Center for Disease Control
and Prevention3, Bureau of Economics, University of Dhaka4

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P-S15-09

Fear Arousal towards Pictorial Health Warning on Cigarette Plain Packaging among Thai
AdolescentsMalinee SOMPOPCHAROEN, Chukiat VIWATWONGKASEM, Pratana SATITVIPAWEE,
Dusit SUJIRARAT, Narumon AUEMANEEKUL, Pimpan SILPASUWAN, Nithat SIRICHOTIRATANA
Mahidol University

P-S15-10

Images of Cartoon Characters and Celebrities on Areca Nut Packs to Lure Children
Devika CHADHA, Ajay PILANKAR
Salaam Bombay Foundation

P-S16-01

TPPA and Tobacco Control: Three Major Threats for ASEAN Countries
Robert STUMBERG, Matthew PORTERFIELD, Deborah K. SY
Georgetown University

P-S16-02

International Trade Law, Plain Packaging and Tobacco Industry Political Activity: The Trans-PacificPartnership Agreement
Gary J. FOOKS1, Jeff COLLIN2, Anna B. GILMORE1
University of Bath1, University of Edinburgh2

P-S16-03

Illicit Cigarette and Potential Revenue Loss in Indonesia
Abdillah AHSAN, Nurhadi WIYONO, Diahhadi SETYONALURI
University of Indonesia

P-S16-04

Estimating the Scope of Illicit Tobacco Trade: Southeast Asia Case Study
Hana ROSS1, Michal STOKLOSA1, Ryan DENNISTON2, Joy TOWNSEND3, Anthony D. SO2
American Cancer Society1, Duke University2, London School of Hygiene and Tropical Medicine3

P-S16-05

Strategies for Moving to the Elimination of Smoking
Ron BORLANDThe Cancer Council Victoria

P-S17-01

Smoke-free Sports to Advocate for a Nationwide Smoke-free Legislation
Kong MOM, Yibee HUANG
Cambodia Movement for Health1, Taiwan International Medical Alliance2

P-S17-02

Tobacco Industry Opposed Total Ban of Tobacco Advertising, Promotion and SponsorshipKong MOM
Cambodia Movement for Health

P-S17-03

Current Situation of Smoking Environment and Measures against Passive Smoking in Golf
Courses in the Kyushu District
Tetsuro KITA1, Muneyoshi TAKAHASHI2, Takeo HASHIGUCHI3, Shin YOSHIHARA4
Musashino Art University1, Kyorin University2, Teikyo University of Science3, St.Marianna University4

P-S17-04

A Survey of Tobacco Advertisements in Magazines Published during 2009 in Japan
Isao WATANABE1, Masako SHIGETA1, Satomi KAN1, Naomi MIKAMOTO1, Kaoru INOUE1,2,
Daisuke MATSUI1, Tadaaki MORI3, Etsuko OZAKI1, Nagato KURIYAMA1, Yoshiyuki WATANABE1
Kyoto Prefectural University of Medicine1, Kyoto Tachibana University2, Kyoto Association for Tobacco
Control3

P-S17-06

Whose Influence Counts: Tobacco Industry or Tobacco Control Groups? Tobacco Industry
Interference in Bangladesh
Taifur RAHMAN1, Monowar HOSSEIN2
Campaign for Tobacco-Free Kids1, PROGGA2

P-S17-07

A Study on Types and Constituents of Tobacco Products Used in Myanmar
Aung TUN, Su Mon MYAT, Thuya AUNG, Phyu The HAN, Tun MYINT
Ministry of Health

P-S17-08

Activities with Non-governmental Efforts in Korea Tobacco Control Policy
Eun Ji KIM, Hong Gwan SEO
Korean Association on Smoking or Health

P-S17-09

Tobacco Control Policy of Chinese TV Drama and the Research on Exposure to Tobacco Lens
Chao SUO
Chinese Association on Tobacco Control

P-S18-01

The Relationship between Public Assistance and Smoking in a Psychiatric Clinic
Yohsuke USUI1, Sawako SAKATANI2, Noriko HIRAGA3, Kouki OKAMOTO4, Masaki IZUMI2
Honda Motor Co.1,Tokyo Musashino Hospital2, Kinen-kobo3, Lawyer4

P-S18-02

Smoking Prevalence and Behaviours amongst a Longitudinal Cohort of Pacific Islands Fathers in
New Zealand
El-Shadan TAUTOLOAUT University

P-Y1-01

The Result of the Smoking Prevention Education in a University
Mieko TANAKA
Hokkaido Pharmaceutical University

P-Y1-02

Smoking Awareness in the Higher Grades of Elementary School and Effectiveness of a Smoking
Prevention Class -Comparison Immediately after and One Year after the ClassTomoko KAWABATA1, Hiromi MORI2The University of Shiga Prefecture1, Omihachinan Community Medical Center2

P-Y1-03

Smoking Habits among Japanese Adolescents: A Nationwide Representative Survey (1996 - 2010)
Osamu ITANI1, Yoshitaka KANEITA2, Maki IKEDA1, Shuji KONDO1, Ryuichiro YAMAMOTO3,
Kenji SUZUKI4, Susumu HIGUCHI5, Hideyuki KANDA6, Yoneatsu OSAKI7, Takashi OHIDA1
Nihon University School of Medicine1, Oita University2, Graduate School of Education, Joetsu Universityof Education3, Suzuki Mental Clinic4, National Institute on Alcoholism, Kurihama National Hospital5,
Yokohama City University6, Tottori University7

P-Y1-04

Survey of High School Teachers about Tobacco
Tatsuhiro KOMOTO1, Yuji SAKURABA1, Takuya SHIDARA1, Emi KISARA2, Keiko KAWASHIMA1,
Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2

P-Y1-05

Gender and Smoking among Adolescents in Thailand: Findings from Wave 5 ITC-SEA (Thailand)
Surveys
Buppha SIRIRASSAMEE1, Tawima SIRIRASSAMEE2, Ron BORLAND3, Geoffrey T. FONG4,David HAMMOND4
Institute for Population and Social Research1, Srinakarinwirot University2, The Cancer Council Victoria3,
University of Waterloo4

P-Y1-06

Tobacco Free Students and Youth
Vijay Bhasker YETAPU, Sobharam MADAKA
VChangeU

P-Y1-07

A Trial of Tobacco-Free Lecture and Workshops for High School Students with Disabilities
Daisuke MATSUI1, Isao WATANBE1, Atsuko AOKI2, Masako SHIGETA1, Etsuko OZAKI1,
Nagato KURIYAMA1, Yoshiyuki WATANABE1
Kyoto Prefectual University1, Kyoto Association for Tobacco Control2

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P-Y1-08

Exploring the Socio-economic Gradients in Tobacco Use among Adolescents Living in New Delhi
and the Psychosocial Factors Affecting This GradientManu R. MATHUR
Public Health Foundation of India

P-Y1-09

College-based Smoking Cessation Intervention for Youths: A Pilot randomized Controlled Study
Takayuki HARADA
Mejiro University, University of Tokyo

P-Y1-10

Japanese Youth Participated in a Tobacco-free Event in Hawaii and Learned the Concept and the
Background
Masako SHIMOZONO1, Misato FURUNO2, Atsuko OHTSUKI2, Kaoru INOUE2,3, Masako SHIGETA2,3,
Nicole SUTTON4, Mark LEVIN5
Kyoto Prefectural University1, Kyoto Prefectural University of Medicine2, Kyoto Association for Tobacco
Control3, REAL, Hawaii4, Hawaii University5

P-O-04Development of Stage-matched Smoke-free Preventive Educational Model for Children and Youthin Hong Kong
Vienna WY LAI, Lisa MM LAU
Hong Kong Council on Smoking and Health

P-O-05

SWOT Analysis on Raising Tobacco Tax in Hong Kong
Lisa MM LAU, Vienna WY LAI
Hong Kong Council on Smoking and Health, HKSAR

P-O-06Media Advocacy in Promoting a Smoke-free Community
Vienna WY LAI, Lisa MM LAU
Hong Kong Council on Smoking and HealthAbstract

ABSTRUCT of Opening Lecture 1
By Kyoichi Miyazaki, MPH, Secretary General of APACT 2013
Dr. David Yen Memorial Lecture:

OL1-01

Evolution and Perspective of APACT

Dr. David Yen Memorial Lecture: Evolution and Perspective of APACT
We often look for a hero or a leader when we need help to

Kyoichi MIYAZAKI
MPH, Secretary General of APACT 2013

get out of a crisis. In 1989, there was such a hero emerged

We often look for a hero or a leader when we needto
help
to getout of fighting
a crisis. In out
1989,ofthere
was sucha hero risk
emergedto setlead
lead
Asiansa serious
healthtrap
Asians fighting out of a serious health risk trap set by international tobacco conglomerates. Helped by US government these
tobacco agents forced open tobacco markets in Japan
1986, Taiwan in 1987
and South
Korea in 1988. In Helped
that year, 1989,
thebyin international
tobaccoconglomerates.
by UStarget was to force open the tobacco market in Thailand. Dr. David Yen, Chairman of John Tung Foundation, saw the comingthesetobaccoforced tobacco
open policy
tobaccothreat of tobacco epidemic in Asia rose up in time government
to call Asians united
againstthe evilagents
US international
that
aimed to increase tobacco sale in Asia. On June 12, 1989 Dr. David Yen, urged by Dr. Ted Chen and Ms. Kwan Mo Chung,markets in Japan in 1986, Taiwan in 1987 and South
organized and pay for the first ever Asia-Pacific Conference on Tobacco or Health in Taipei that was attended by 14 tobacco
control experts. The event gave birth to a new internationalorganization
named
APACT
Association
for theKorea NGO
in 1988.
In thatyear,
1989,(AsiathePacifictarget
was to force
Control of Tobacco).
Dr. David YEN
open a themarket andin public
Thailand.
Dr.thatDavid
Yen, Chairmanof John Tung
Soon after the birth, Dr. David Yen led APACT to launch
seriestobaccoof media campaign
policy debate
culminatedin US Congressional hearing. To avoid further public uprisings USTA brought the Thailand case to GATT for judgment. GATT eventually pronounced that forthe coming
threatof ThaitobaccoinandAsia
up advertisementin time to callthe principal of fair trade practice Thai should openFoundation,
tobacco market saw
for international
tobaccosale but
couldepidemic
charge tariffs
ban rosecigarettethat often targeting at women and youth.
Asians united against the evil US international tobacco policy that aimed to increase
In Japan, the 6th World Conference on Tobacco or Health was held in Tokyo in 1987 when the foreign tobacco was to import without a tariff. We have not realized
tobaccoin Asia.
On June
1989JTDr.
urged byDr. TedChenthat Japanese government had accepted tobacco trade.
Whilesale
Japanesegovernment
tried to12,
supportas ifDavid
it were Yen,
still monopoly,
Thailandhas seta lawandban Ms.
any form of tobacco advertisement. In 2007, Taiwan raised cigarette tax and used 10% of collection for health promotion and tobacco control. This was a great
Mooften
Chung,
organizedpay
the tofirst
ever inAsia-Pacificcampaign organized by John Tung Foundation. Dr.Kwan
David Yen
said that
Asia is like anda familyandfor
we havebe unitedfighting againstConference
International on
tobacco industry to promote health for all Asians. We
shouldmove
forwardtoprotect
ourhealthylife
andenvironmentbythespirit
of
Dr.
David
Yen,
Tobacco or Health in Taipei that was attended by 14 tobacco control experts. honorary
The eventPresident of APACT.

gave birth to a new international NGO organization named APACT (Asia PacificOL2-01The Endgame

Association for the Control of Tobacco).

Judith MACKAY
Soon after the birth, Dr. David Yen led APACT to launch a series of media campaign andWorld Lung Foundation, Bill and Melinda Gates Foundation

policyculminatedin US
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Others believe that the tobacco epidemic is unlikely to yield to today's evidence-based interventions, and question whether new and radical solutions are
required, including fundamental reform of the tobacco industry – whether commercial or government monopoly. New measures suggested include administrative
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when the foreign tobacco was to import without a tariff. We have not realized that
Either way, there will need to be a much greater and immediate emphasis on price policies and cessation in all Asian countries to reduce consumption among
already-users.
Japanese government had accepted tobacco trade. While Japanese government tried
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to come, so for many countries in Asia, the endgameto
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health2013;22
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(Acknowledgement: The end of tobacco. Tobacco Control
Supplement
Tung Foundation.

PL1-01

Dr. David Yen often said that Asia is like a family and we have to be

Progress in Tobacco Control: Evidence
Countries
at the Forefrontof Tobacco
Controlunited fromin fighting
againstInternational
tobaccoindustry to promote health for all

Ron BORLANDThe Cancer Council Victoria
Australia, like a range of other largely western countries has been seriously engaged in tobacco control for more than 25 years. This presentation provides asummary of the impacts of the main policy initiatives, primarily using data from population surveys to track changes in prevalence, and from the ITC survey andother sources to demonstrate the impacts of the interventions. The presentation will show that tax policies, mass media campaigns and strong health warnings
on packs and at point of sale, and increased restrictions on tobacco promotion have all contributed in positive ways to prevention and/or cessation. Similarly,
the Australian approach to cessation assistance which has focussed on mass disseminable aids and the use of pharmacotherapies has been successful. Further
increased implementation of smoke-free laws in recreational venues including bars have had positive effects in protecting non-smokers and are widely acceptedby smokers. However, bans on the terms “Light” and “Mild” have had minimal effects, so not all policies have had even part of their desired effects. The paper
will also present early evidence on the impacts of plain packaging legislation. Even with all this activity, there is evidence that cessation rates in Australia havestalled, getting more existing smokers to quit successfully is providing difficult. The author has concluded that without radically new policies, we will not resolve
the tobacco problem. The presentation provides an analysis of options for moving forward. We should move as soon as possible to ban filter venting of cigarettes
and other engineering features designed to increase their appeal particularly to non-smokers. I argue that we also urgently need to evaluate the potential of newtechnologies to provide low harm forms of nicotine that might act as substitutes for smoking for those unable or unwilling to stop smoking. Considering options
to complete abstinence from nicotine is likely to be a particularly important strategy for some of the highly disadvantaged groups where smoking rates are thehighest. The presentation ends by relating this agenda for high income countries to the rest of APACT.

71

PL1-02

Where Are We with FCTC? Achievement and Challenges in Hong Kong

Lisa LAU
Hong Kong Council on Smoking and Health
The tobacco control measures implemented by the Hong Kong Government since the early 1980s align with the WHO Framework Convention on Tobacco
Control’s (FCTC) aim in reducing the demand and supply of tobacco. China signed the FCTC in 2005 and it came into effect in 2006. Its application extended
to Hong Kong. The Hong Kong Government has taken a progressive and multi-pronged approach in tobacco control through legislation, law enforcement,
education, promotion, promotion of smoking cessation and taxation.
The tobacco control legislation has been strengthened in Hong Kong after ratification of the FCTC. In 2007, statutory no smoking areas have been expanded
to cover all indoor workplaces, restaurants and most public places helping to protect people from secondhand smoke. All forms of tobacco advertisements,
promotion and sponsorships were banned in Hong Kong. Six pictorial health warnings have also been adopted on packets of tobacco products covering at least
half of the cigarette packaging. The tobacco tax was also increased by 50% and 41.5% in 2009 and 2011 respectively to encourage smoking cessation and deter
youngsters from picking up the habit.
With the concerted efforts of the Government and various supporting organizations, the smoking prevalence in Hong Kong has dropped significantly from 23.3%
in the 1980s to 11.1% in 2010.
Although Hong Kong is now one of the regions with the lowest smoking rate, there are still over 650,000 smokers. We may encounter challenges to further reduce
the smoking prevalence, especially from the tobacco industry’s increasing interference in tobacco control policies. Hong Kong Council on Smoking and Healthwill continue to work in close partnership with the Government and various sectors of the community to strive for a smoke-free Hong Kong.

PL1-03

Where are we with the FCTC? Achievements and challenges

Prakit VATHESATOGKIT
Action on Smoking and Health Foundation Thailand
The Framework Convention for Tobacco Control (FCTC) went into force in February 2005. It is the only health related international treaty aiming at assisting
nations to protect current and future generations from the devastating hazards of tobacco use and exposure to tobacco smoke. Currently 176 countries have
ratified the treaty. It has been hailed as the most rapidly embraced and implemented treaty in United Nation's history. The Global Progress in the Implementationof the FCTC, released at the Conference of the Parties (COP5) meeting in November 2012 showed that the pace of global progress remains sub-optimal. Of the
126 Parties submitting reports to the Convention Secretariate, the implementation on so called " best buy" interventions for tobacco control reveals that 93 of
120 Parties have national legislation protecting the public from exposure to tobacco smoke, 53 Parties have legislation requiring pictorial health warnings on
tobacco packaging, 86 Parties have comprehensive bans on tobacco advertising/promotion/sponsorship, and most Parties have imposed some form of tax on
tobacco products. The number of Parties which have implemented various Articles and Guidelines of FCTC, imply only the “Quantitative”, and no detail on the“Qualitative” aspect of the implementation.
The report also noted four constraints and barriers to the effective implementation of the FCTC: interference by the tobacco industry in tobacco control policy
development, insufficient political will, insufficient financial resources for tobacco control, and poor inter-sectorial coordination within the country. The funding
for the treaty implementation it self has been a problem, with inadequate core budget from voluntary assessed contribution (VAC) by Parties and the need torely more and more on extra budgetary contributions. However, there are a number of countries who have adopted progressive tobacco control measures in linewith FCTC Guidelines, such as Australia's plain packaging provisions, Thailand's 85% graphic health warnings, Mauritius and Vietnam's ban of tobacco industry
CSR activities, Singapore's ban of duty-free cigarettes, Brazil's implementation of Article 5.3, with Bhutan the only country to ban the sale and production of
tobacco products.
The most challenging threat to the implementation of the FCTC is the proliferation of free-trade agreements, with investor-state agreement clauses threatening toblock/intimidate Parties from implementation various obligations under the FCTC. In the global progress report, about 17 countries earmark funding for tobacco
control and other health programs. There is an urgent need for Parties to overcome these kinds of internal and external barriers if progress in the implementationof the FCTC is to be made.

PL2-01Fighting NCDs Together with Other Health Problems

Douglas W. BETTCHERWorld Health Organization
The UN General Assembly held a high-level meeting to elevate noncommunicable diseases (NCDs) as a priority for the international community and adopted
a political declaration of commitment for a multi-sector response to NCDs in September 2011, which was only the second UN meeting of its kind devoted to
global health. The Political Declaration makes a clear call for including noncommunicable diseases in health-planning processes and the development agenda ofeach Member State. Following the Political Declaration on NCDs, WHO Member States developed a global monitoring framework, including 25 indicators, andnine voluntary global targets for the prevention and control of NCDs to enable global tracking of progress in preventing and controlling major noncommunicablediseases - cardiovascular disease, cancer, chronic lung diseases and diabetes - and their key risk factors. A 25% relative reduction in premature mortality fromnoncommunicable diseases by 2025 has already been adopted by the World Health Assembly in May 2012. Tobacco control is a major contributor to achieve
this mortality reduction and a target has been proposed for a 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years by 2025. For
the purpose of promoting global action towards achieving the global targets for the prevention and control of NCDs, WHO also developed a draft Global NCD
Action Plan for the period 2013–2020, consistent with WHO’s existing strategies and tools on tobacco use, harmful use of alcohol, unhealthy diet and physicalinactivity. Both the global monitoring framework and the draft Global NCD Action Plan 2013-2020 will be submitted, through the Executive Board, to the
Sixty-sixth World Health Assembly for consideration and possible adoption. The UN Political Declaration defines that the NCD epidemic should be addressedsynergistically with numerous other health problems such as TB, HIV/AIDS, maternal and child health by all sectors of government and society. This is because:• There is a growing double burden worldwide. An increasing number of countries face a double burden of disease as the prevalence of risk factors for chronic
diseases such as diabetes, heart diseases and cancers increase and many nations still struggle to reduce maternal and child deaths caused by infectious diseases,
according to the 2011 United Nations statistical health report.
• NCDS threaten the attainment of globally endorsed MDGS due to the important links between the diseases. For example, tobacco use by mothers increases
the chances of low birth weight, which may lead to higher child mortality; people who smoke or have diabetes are at an increased risk of developing TB; HIV/AIDS is associated with higher rates of some types of cancer.
Therefore, countries should develop a health system to synergistically address the full range of the health threats in different areas, building on existing platforms
and existing consensus. For example, to integrate NCD prevention and control, including tobacco dependence treatment into health programmes dealing with
HIV/ AIDS, TB, and malaria as well as child and maternal health in primary care; to add treatments that are relevant for NCDs to existing platforms for poolingthe procurement and delivery of drugs in low- and middle-income countries to ensure a more predictable and affordable supply.

72

PL2-02
Keizo TAKEMIHome of Councikkors

PL2-03

Tobacco Control Measures Toward 12% of Adult Smoking Rate as National Target under Health Japan 21 (The 2nd Term)

Hiroyuki NODA
Ministry of Health, Labour and Welfare
In Japan, 129 thousands persons were estimated to be dead by non-communicable diseases (NCDs) due to tobacco smoking annually. Whereas adult smoking
rate has been rapidly reducing for a last decade, tobacco smoking remains to contribute to the largest number of deaths due to NCDs in Japan. As high bloodpressure is the only risk factor contributing to excess deaths similarly to tobacco smoking, tobacco control and hypertension control are major challenges toextend healthy life expectancy in Japan.
On April 1st, 2013, we started Health Japan (the 2nd term), which includes a national target for adult tobacco smoking. We set 12% of adult smoking rate until
2022 as the national target, which was calculated as percentage of smokers after exclusion of smokers who want to quit tobacco smoking in National Health
Nutrition Survey 2010. As Health Japan 21 (the 2nd term) aims finally to extend healthy life expectancy and reduce health disparity, we have to further promote
tobacco control measure toward 12% of adult smoking rate as control of major risk factors.
To prevent deaths and disabilities caused by tobacco use, Ministry of Health, Labour and Welfare conducts some of tobacco control measures including risk
assessment of tobacco use and tobacco constituents, public awareness, tobacco cessation, and protection from exposure of tobacco smoke. In April of 2006,
we included treatment for nicotin dependency in list of national health insurance. But, annual number of users for the nicotin dependency remains only 100
thousands of patients, suggesting that we need to further promote use of treatment for smoking cessation amongst patients with nicotin dependency. For policy of
support for smoking cessation, we published “Manual for Smoking Cessation (the 2nd edition) and “Standard Health Checkup and Healthcare Guidance Programs(The revised edition)”, which aim to promote smoking cessation support in health checkups and health guidance as national system for NCDs prevention andcontrol. We also started “Tobacco Quitline” which set Tobacco Counselors who conduct tobacco cessation support and public awareness as well as coordinationof human resources and infrastructure amongst community, workplace and medical institutes.
We started new challenge toward 12% of adult smoking rate under Health Japan 21 (the 2nd term) to extend healthy expectancy and shorten health disparity from2013.

PL2-04

Smoking Prevention Strategies: Is Education Enough?

Peter LANDLESSGeneral Conference of Seventh-day Adventist, International Commission for the Prevention of Alcoholism and Drug Dependency
Transnational tobacco companies continue to attempt to recruit smokers. Noncommunicable diseases have reached an all-time high and smoking contributes
very significantly to these statistics. There is not only a need to help current smokers quit the habit, but also a very urgent need to prevent initiation of smoking.
This paper will sketch the demographics of smoking in Japan with special emphasis on the adolescents and then focus on interventions which may be helpful inpreventing young people from initiating at risk behaviors. Many initiatives have focused mainly on education and this is important; however there are additional
factors which need to be implemented if smoking initiation is to be curtailed. Helping young people resist the habit of smoking may well influence healthy
choices in other aspects of life thereby improving health and well-being and help to decrease NCDs.

73

PL3-01

Global Excise Tax Systems and Administration

Ayda YUREKLIWorld Health Organization
Price and tax increases are the most cost effective tobacco control policy that decreases tobacco use. Price increases make tobacco products less affordable,
especially for low-income groups and youth, therefore, discouraging their use. In many countries, tobacco products are subject to some form of taxes. The mostcommon form of taxes levied on tobacco products are excise taxes and value-added tax (VAT). The rates, structure and the application of excise taxes vary bycountry and by the type of tobacco product. This presentation will focus on global evidence on excise tax application and the problems countries usually facewhen implementing tax policies. The presentation will also summarize WHO’s work with countries’ Ministries of Finance on tobacco taxation and will present
solutions possibilities already adopted by a number of countries.

PL3-02

Tobacco Taxation in the Pacific-The Tonga Example

Siosifa Tuitupou TUÚTAFAIVA
Minister for Revenue, Tonga
The presentation will speak about taxation in Tonga and the actions the government in taking to improve its implementation.

PL3-03

Recent Developments in the Philippines Tobacco Taxation System

Jeremias PAUL
Department of Finance Philippines
The presentation will focus on Philippines’ recent change in the taxation of cigarettes, which was adopted following a long battle and which simplifies the system
while increasing tax rates substantially.

74

PL3-04

Tobacco Taxation in Turkey, a Success StoryÜnal TAYYAN
Ministry of Finance, Republic of Turkey
The presentation will describe Turkey’s experience in recent years in increasing substantially tax rates and the successful actions taken to improve tax
administration and monitoring to reduce incentives for illicit trade and improve tax revenue collection.

PL3-05

Tobacco Taxation in Russia and Future Plans

Ilya TRUNIN
Ministry of Finance Russian Federation
The presentation will focus on Russia’s recent measures to increase taxation on cigarettes in the next decade and the challenges faced in implementing suchchanges”.

PL3-06

Indonesia’s Tobacco Taxation, The Roadmap to Simplify Its Structure

Astera Primanto BHAKTICenter For State Revenue Policy, Fiscal Policy Agency, Ministry of Finance
The presentation will describe Indonesia’s complex tax system and will speak about the government’s effective actions in recent years to simplify the system
and improve tax administration.

75

PL4-01

Philippines: Are We Winning against the Tobacco Industry?

Edgardo Ulysses N. DOROTHEO
Southeast Asia Tobacco Control Alliance, Framework Convention Alliance
Since ratifying the FCTC in 2005, the Philippines has made tobacco control progress in some ways but lagged in others. The passage of the Tobacco Regulation
Act of 2003 (or Republic Act 9211) was a hard fought legal milestone for tobacco control advocates, but it falls short of even the minimum FCTC requirements inmany respects. As a result of strong tobacco industry (TI) lobbying, RA 9211 allows for designated smoking areas, requires only small, text-only pack warnings,
and does not impose a comprehensive ban on tobacco advertising, promotion, and sponsorships. It also includes the TI as a member of the inter-agency committee
tasked with overseeing the law’s implementation, a direct violation of FCTC Article 5.3. Subsequently, Philippine advocates have been working to plug these
legal loopholes but have encountered TI interference at every turn: misinformation and legal intimidation of local governments implementing 100% smoke-freeenvironments, five separate court cases filed against the Department of Health’s order requiring pictorial warnings, and circumvention of the outdoor advertisingban.
Fortunately, local government autonomy has allowed for a steadily growing wave of 100% smoke-free local laws over the past few years, and the Civil Service
Commission in 2010 jointly issued with the Department of Health a memorandum seeking to protect the bureaucracy from TI interference, the first of its kind inglobal tobacco control. More recently, the government was able to successfully pass a sin tax reform law that significantly increased tobacco taxes primarily for
public health reasons and allocated sin tax revenues for health purposes and for alternative livelihoods of tobacco farmers.
Such political leadership in the face of a strong TI lobby signals hope for the Department of Health’s National Tobacco Control Strategy. Full and effective
FCTC-compliance will only be possible, however, when a whole-of-government approach is applied, in addition to amending RA 9211. This will mean the likesof the Department of Trade and Industry and the Department of Agriculture recognizing their roles and responsibilities in public health and choosing to protect
it rather than protecting the TI’s commercial interests.

PL4-02

Tobacco Control in Japan. What It Is and What It Should Be.

Manabu SAKUTA
Japan Society for Tobacco Control
The Framework Convention on Tobacco Control has been in effect since February 2005.
However this epoch making event for world tobacco control has realized almost no significant
changes due to the intrusion of the tobacco industry and Ministry of Finance in Japan.
Contrary to article 8, the Government still hasn’t passed a law to protect Japanese people frompassive smoking. Contrary to article 11, the Ministry of Finance is still permitting old style
packaging without significant health warnings and concerning article 13, no restriction on
tobacco advertising is possible except a self-imposed control by the tobacco industry.
The Japan Society for Tobacco Control has made a passive smoking prevention bill andpresented a petition to the Minister of Health, Labor and Welfare with four related bills.
Regardless of the fact that the Japanese Government hasn’t changed their policy, Japanesepeople are successfully avoiding the ill effects of Tobacco. There appears in particular, asteady decline in the prevalence rate which is now around 20%. They know tobacco is bad
for their health and beauty, and above all, tobacco is not cool any more. However, uneducatedpeople are still smoking. To save their lives, we have to cooperate, and seek a Champion fromamongst our politicians.
Curriculum Vitae: 1973 Graduated from Medical School, Tokyo University. MD, Ph-D.
1981 Visiting Assistant Professor, University of Minnesota. 1982 Head of Dpt. Neurology,
Japanese Red Cross Medical Center. 2000 Professor of Neurology, Kyorin University. 2002
Chief Professor of Medicine I, Kyorin University. 2005 Board Chairman of the Japan Society
for Tobacco Control. Fellow of the Royal Society of Medicine, London.

PL4-03

Tobacco Control in Japan, 2013. ( --- ; against)
Curriculum Vitae：1973 Graduated from Medical School, Tokyo University.

MD, Ph-D. 1981 Visiting Assistant Professor, University of Minnesota. 1982
FCTC Implementation in South Korea, Still Have a Long Way To Go

Hong Gwan SEO
National Cancer Coutrol Institute, National Cancer Center

Head of Dpt. Neurology, Japanese Red Cross Medical Center. 2000 Professorof Neurology, Kyorin University. 2002 Chief Professor of Medicine I, Kyorin
University. 2005 Board Chairman of the Japan Society for Tobacco Control.

Fellow
the Royal Societyof Medicine,
London.
The Framework Convention on Tobacco Control (FCTC) is the first international treaty to fightthe ofconsistently
increasing
globaltobacco use. As of August,
2013, 176 countries are making efforts to save lives from tobacco. As a Party of the treaty, South Korea should also work hard to implement the FCTC for better
tobacco control.
The last cigarette tax increase in South Korea was 8 years ago and there has been no increase in tax since, a tactic recognized as the most important in reducing
tobacco use. So considering inflation, the real price of cigarettes in Korea has been decreasing and this led to the recent increase in smoking rates.
The price of a cigarette pack is approximately USD $2, the lowest among 25 OECD member countries whose average price is about USD $6.
In relation to the FCTC Article 6, we levied health promotion tax on electronic-cigarettes in 2011.(FCTC Article 6)
Regarding FCTC Article 8, most public places, such as public buildings and public transports, have been designated smoke-free. Since December of 2012,
restaurants and bars larger than 150 square meters have also been designated smoke-free. This will be expanded to all restaurants and bars by 2015. Moreover,the local governments have the authority to designate smoke-free areas. (FCTC Article 8)
On Article 11, a health warning label (words rather than pictures) comprises 30% of a cigarette pack surface. 6 carcinogens from tobacco are included in thehealth warning label as well as the quitline number. However, a pictorial health warning is yet to be adopted. (FCTC Article 11)
Regarding Article 13, cigarette ads on TV, radio, newspaper, and Internet have been banned since 1995, while only ads in magazines were allowed. The allowed
number of ads has decreased from 60 times a year to 10 in 2012. (FCTC Article 13)
Since 2005, Korea has operated smoking cessation clinics in 250 health centers where counselors provide behavioral therapy and pharmacotherapy for free. Also,in 2006, the National Cancer Center established the Quitline service. (FCTC Article 14)
We still have a long way to go. One of the most urgent issues is to counter tobacco industry, the vector of tobacco epidemic. However, South Korea has not
focused on the vector and we need to establish an alliance with the government, opinion leaders, and NGOs.

76

[APACT 2013 Youth Conference]
Pre-conference of The 10th Asia Pacific Conference on Tobacco or Health (APACT)

United for Tobacco Free World. “What should WE do?”This is the first APACT youth conference aiming to share fresh ideas and perspectives on tobacco control among young generation in Asia-pacific region andto engage, inspire and empower youth in tobacco control. This youth conference was formed in response to growing recognition of the critical role that youth
plays in tobacco control, both as a target group and as partner. Youth conference was launched this year for the first time with a mission to bring fresh ideas fromseveral countries in Asia and Pacific to forefront and increase awareness to tobacco control among young generation. The youth conference constitutes a sourceof knowledge and innovation, and provides participants an excellent resources and opportunities to make a vital contribution to the youth specific agenda intobacco control and other important tobacco issues.
This youth conference provides knowledge and skills to participants intended to1. Raise awareness for tobacco epidemics especially among young generations and create global young leaders in next generations.
2. Create Asia – pacific networks among young generations in order to address tobacco issues.
Programs are as follows;・Key Note lecture 1“Youth and tobacco advertising, promotion and sponsorship”
Dr. Douglas W. Bettcher
Director, Prevention of Non-communicable Diseases (PND), World Health Organization
・Key Note lecture 2“What is done and what is to be done”
Dr. Yumiko Mochizuki
Division Chief, Tobacco Policy research Division, Center for Cancer Control
・Luncheon Session(TBA)
Dr. Akinori Kuruma
・Poster presentation
Share good practices related to tobacco control among countries.
・World Café
Divided into small groups and discuss challenges and countermeasures for tobacco epidemics.
・Keynote remarks“Youth Activism: Empowering the Next Generation of Tobacco Control Partners!”
Nicole Sutton
The outcomes of this youth conference will be reported at the APACT symposium 19 on 21st.

[APACT 2013 Related Conference]
Action planning and Training of National TB Programme (NTP) Managers on Integrating Brief Tobacco
Interventionsinto TB treatment Programme in Primary Care

Workshop for action planning and training of NTP managers on integrating brief tobacco interventions into TB
treatment programme in primary care
A confirmed causal association between active or passive exposure to tobacco smoke and various outcomes of tuberculosis (TB) requires the National TB Control
Programmes (NTPs) and the National Tobacco Control Programmes to join forces to tackle both the TB and the tobacco epidemic.
In many countries, prevalence of smoking is much higher among TB patients than in the general population. TB care providers are typically in regular contact
with TB patients under the directly observed therapy, short-course (DOTS) for a minimum of six months. This represents a unique opportunity to deliver smoking
cessation interventions to a large number of tobacco users. Therefore, joint actions must be taken within the health care system, especially at primary care level,to support every TB patient who is a smoker to quit.
This 3-day workshop has been funded by the Ministry of Health, Labour and Welfare, Japan to build the capacity of the NTPs and the National Tobacco Control
Programmes in four priority Asia-Pacific countries to integrate brief tobacco interventions into DOTS programmes in primary care. The target audience will be
the tobacco control focal persons and the NTP managers from the four selected countries.
The workshop will be conducted by WHO in collaboration with the National Cancer Centre in Japan and Japan Anti-Tuberculosis Association. Each country willdevelop a concrete one-year action plan for implementing the project at the end of the workshop with the objectives to:・Introduce effective system changes in 2 to 5 PHC centres/DOTS centres to support the delivery of brief tobacco interventions (5As and 5Rs) as part of
TB treatment;
・Train 30 to 60 TB care providers on brief tobacco interventions; and・Support each trained TB care provider to identify and provide brief tobacco interventions to at least 10 TB patients who smoke by 31 March 2014.

77

S1-01

Enforcement of Smoking Ban: Hong Kong Experience

Christine WONG
Hong Kong Special Administrative Region
Over the years, the Government of the Hong Kong Special Administrative Region has been taking a multi-pronged approach in its tobacco control policies,
comprising legislation, enforcement, publicity, education, smoking cessation and taxation, with a view to minimising the harmful effects of tobacco on the public
and the community.
The Tobacco Control Office (TCO) was established under the Department of Health in 2001 to promote a smoke-free culture. The Tobacco Control Inspectors(TCIs) of TCO are empowered to enforce smoking ban in Hong Kong.
In 2007, Hong Kong amended the legislation to extend the smoking ban to cover all indoor areas of workplaces and public places, including restaurants and bars,
as well as some outdoor areas such as schools, parks and beaches. Hong Kong also introduced a fixed penalty system for smoking offences in 2009. People
smoking in statutory no smoking areas are liable to a fixed penalty of HKD$1,500 (US$192).
TCO established a 24-hour hotline system to collect complaints from the public on smoking offence. Designated tobacco control inspectors of TCO carry out
investigation on every complaint case and inspect the premises concerned. To enhance deterrent effect, TCO takes vigorous enforcement actions and initiates
proactive inspections at black-spots where smoking offences/complaints are prevalent. From time to time, TCO also conducts joint inspections and enforcement
actions with other law enforcement agencies.
TCO regularly evaluates its tobacco control efforts by monitoring various performance indicators. After the enactment of the amended Smoking (Public Health)Ordinance on 1 January 2007, TCO conducted a series of evaluation which revealed that over 90% of citizens supported smoke-free workplaces and restaurants
while patrons in over 95% of the restaurants complied with the statutory requirements. Since the introduction of the fixed penalty system, around 7,500 to 8,000
fixed penalty notices were issued each year.
Local enforcement is one of the key factors to the success of smoking ban. With the implementation of tobacco control measures, the proportion of daily smokers
among the population aged 15 and above dropped steadily from 23.3% in the early 1980s to 11.1% in 2010.

S1-02

Legislative Actions by the Local Autonomy

Yu-Jin PAEK
Hallym University Medical College
In 2012, significant changes were made to Korea's People's Health Promotion Act to address the impact of tobacco smoking on the community. People's Health
Promotion Amendment Bill 2011 was passed by Korean Parliament on 7th July 2011. This included prohibition of smoking inside public places. This went into
effect on 8 December 2012. PC game rooms and comic book stores were designated as smoke-free zones since 8 June 2013 as well. This act also included
the total smoking ban in the restaurants, pubs and clubs larger than 150 ㎡. And by early 2015, smoking will be gradually prohibited regardless of their sizes.
Smokers who do not follow this law will be fined up to 100 US dollars and the owners or managers will be also fined maximum of 5 grand. According to this act,
cigarette vending machines in the expanded smoking-free areas have to be removed.
Local governments' legislative activities to protect their citizens from secondhand smoke in certain places were newly guaranteed by this law. On the local level,
many local governments have taken part in the establishment of an ordinance after the implementation of the act. Eleven wide-area autonomous communities and
144 municipalities exist as of 1 January 2013 in Korea. Their legislative activities may vary according to the situations on which local governments are placed.
For example, the number of smokers who have been fined due to violation of the revised law was increasing because of a stronger crackdown by some local
governments. The Seoul Metropolitan Government imposed fines on 11,970 smokers who violated the new regulations, whereas only 578 smokers were fined
before the introduction of the new law. Furthermore, all of the city's bus stops and taxi stands were already designated as smoke-free zones in Seoul.
Most city parks were designated to be non-smoking areas by most of local autonomous communities. Several beaches including Haeundae Beach in Pusan citywere also pronounced smoke-free. Some streets and public squares were set to be declared as smoke-free zones.
Although these activities by the local autonomies were likely to be successful, there are some obstacles to overcome.
Firstly, there are difficulties with implementation because of lack of human resources to enforce the bylaw.
Secondly, there are issues involved in the law enforcement among smokers and business owners.
Lastly, organized interruption by tobacco companies to diminish the legislative activities should be closely monitored.

S1-03

To Persuade Local Government in the Establishment of Non-smoking Regulations

Masatoshi SEKIGUCHI
Smoke-Free Caravan Association
In March 2009, Kanagawa Prefecture established regulations to stop second-hand smoking and in August 2011, the Smoke-Free Caravan Association was set up
to spread this work across the whole country. The staff are: Honorary President Tadao Shimao, President Takafumi Hirama, Vice-President Akira Ooshima, VicePresident Manabu Sakuta, Vice-President Jun Tanaka, Vice-President Kazunori Nakakugi, Vice-President Michio Nakayama, Advisor Shigefumi Matsuzawa
who was the Kanagawa Prefectural Governor at the time the regulations were established and a current member of the House of Councillors, and myself as
the Chief Executive. Currently we have reached the third stage in sending requests to all Prefectural Governors and Congress Chairmen asking for the early
enactment of a second-hand smoking prevention regulation. Today I would like to talk about this progress with the help of a slideshow presentation.
• Stage 1 (17th -24th September 2009: 9 Prefectures)(Kanagawa) – Shizuoka – Aichi – Gifu – Shiga – Kyoto – Nara – Wakayama – Osaka – Hyogo• Stage 2 (31st March – 10th April 2010: 13 Prefectures)
Saitama – Gunma – Niigata – Yamagata – Akita – Aomori – Iwate – Miyagi – Fukushima – Tochigi – Ibaraki – Chiba – Tokyo• Stage 3 (7th – 17th April 2013: 14 Prefectures)
Yamanashi – Nagano – Toyama – Ishikawa – Fukui – Tottori – Shimane – Hiroshima – Ehime – Kochi – Tokushima – Kagawa – Okayama – Mie
There are many people gathered here today from all over the country so I would like to show you what we plan to do next.
• Stage 4 ( 31st August – 7th September 2013)
Hokkaido (Obihiro – Kitami – Asahikawa – Iwamizawa – Sapporo – Hokkaido Government Office – Otaru – Tomakomai)• Stage 5 (planned Spring 2014)
Yamaguchi – Fukuoka – Saga – Nagasaki – Kumamoto – Kagoshima – Miyazaki – Oita
• Stage 6 (planned Autumn 2014)
Okinawa78

S1-04

Second-hand Smoke Exposure of Children in Cars in New Zealand: Repeated National Survey Data

Benjamin HEALEY1, Richard EDWARDS1, Nick WILSON1, George THOMSON1, Janet HOEK1, Steve TAYLOR2
University of Otago1, AUT University2
Background: Exposure to second-hand smoke (SHS) causes adverse health outcomes for children and adolescents, and is implicated in increased risk ofsmoking initiation. Because private cars represent an important potential source of SHS exposure for children, many jurisdictions have banned smoking in carsin the presence of children. However, other jurisdictions, like New Zealand (NZ), have proposed but not yet implemented legislation, and have instead reliedon mass media campaigns to try to reduce exposure. Aim: To explore trends in and patterns of in-vehicle SHS exposure among 14-15 year old children in NZ.
Methods We analysed data from a school-based national survey of New Zealand’s Year 10 students from 2006-2012 (the ASH Year 10 surveys). Participants
were asked whether, in the past week, others had smoked around them in a car or van. Students who reported exposure on at least one day in the past week wereclassified as exposed to second-hand smoke (SHS). Results Response rates varied between 42% and 53%, with between 25,000 to 33,000 participants in eachsurvey. The sample characteristics were similar to the New Year 10 population by gender, socio-economic status (SES) and ethnicity.
Exposure to SHS in cars reduced between 2006 and 2012 from 31% to 22%. However, Māori (indigenous population) students had approximately twice therisk of exposure as NZ European students and students from low SES schools also had significantly higher SHS exposure.. Multivariate analyses showed thestrongest independent predictors of exposure were smoking by parents, siblings and friends. The crude associations of SHS exposure in cars with ethnicity and
SES were removed or greatly attenuated in the multivariate analysis. The 2011 survey collected more detailed data on the frequency of exposure to SHS in theprevious week. Of the children reporting any exposure, over half (56%) were exposed on three days or more and over a quarter (26%) were exposed on every day.
Conclusions Smoking in cars remains an important source of children’s exposure to SHS in NZ. The marked disparities in exposure by ethnicity and SES
contribute to health inequalities in NZ, and suggest that further measures are required to protect children from SHS. More generally, the findings suggest
legislation to prohibit smoking in cars with children in NZ should be urgently introduced. Acknowledgements: The authors thank the students who participatedin all of the ASH New Zealand ‘Year 10’ surveys. The ASH surveys were funded by the NZ Ministry of Health.

S1-05

Awareness of Advertisement and Campaign of Smoke-Free Melaka Policy among People in Melaka: Findings from
Evaluation of Smoke- Free Melaka Intercept StudyYahya BABA1, Maizurah OMAR2, Rahmat AWANG1,2, Noraryana HASSAN3, Nur Hanani JASNI2, Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH4,
Pete DRIEZEN4, Mary THOMPSON4, Geoffrey T. FONG4My Sihat1, Clearing house for Tobacco Control2, Melaka State Health Departments3, University of Waterloo4
BACKGROUND: Melaka had implemented a 100% smoke free city beginning June 2011 with the aims to protect women and children living with smokers.
Awareness of the project can be influenced by means of well-designed advertisement and campaign. The advertisement and campaign were made widely visible
to people through numerous medium, i.e., radio, posters/signage, billboards/digital billboards, newspaper/magazines, shop/store windows, buses, trishaws andt-shirts.
OBJECTIVES: To determine the level of awareness of advertisement and campaign as reported by people in Melaka with respect to demographic characteristics.
METHODOLOGY: Data were collected in June 2012 by using systematic intercept sampling. A total of 1039 adult within smoke-free zones were interviewed
face-to-face in this study. Awareness of Smoke-free Melaka advertisement and campaign were measured by the following questions: In the last six months, haveyou seen or heard something about Smoke-free campaign, or/and have you noticed advertisements that talk about the dangers of smoking, or encourages quitting
in any of the following places (i.e.: radio, posters/signage, billboards/digital billboards, newspaper/magazines, in shop/store windows, on side buses, on trishaws
and on t-shirts). Descriptive analysis, univariate and multiple logistic regressions were applied.
RESULTS: The advertisement and campaign had resulted in high salience among people in Melaka. Noticing to these advertisements and campaigns werevery high among smokers (93.6%), non-smokers (95.6%), resident (97.7%), temporary residents (91.4%) and visitors (86.1%). Various media channels utilized
in the advertisements and campaigns were noticed by people. The most frequent channel where advertisement caught their attention was from posters/signage(92.5%) billboards/digital billboards (77.0%), windows/inside of shops (73.8%), newspapers/magazines (72.8%), buses (63.3%), radio (60.8%), t-shirts (32%)
and trishaws (27.6%). Logistic regression showed that Malay people, local resident and those with higher education level reported significantly higher in noticing
advertisement.
CONCLUSION: Smoke-free Melaka advertisement and campaign achieved high level awareness into the people of Melaka and was received positively by both
smokers and non-smokers.

S1-06

The Changes in Smoking Related Behaviours, Second Hand Smoke and Smoking Cessation after the Smoking Ban in
Izmir, Turkey

Pakize A. TURAN1, Gul ERGOR2, Muzaffer O. TURAN3, Sinem DOGANAY2, Oğuz KILINC2
Afyon State Hospital1 , Dokuz Eylul University2, Bolvadin State Hospital3
AIM:The aim of the study is to determine the views,the change of second hand smoke quantity,the variation of smoking cessation,people’s smoking related
behaviours after the publishment of law which prohibits use of tobacco products in closed public areas.
MATERIAL-METHODS:Questionnaire including 47 questions was performed to 600 people,which presents the overall Izmir city population.
RESULTS:53,7% of participants were female and 46.3% was male;the mean age was 41,5±15,6. 232 were smoking(39%), 257 were never smoked(42%) and
111 quited smoking(19%).Men were smoking more than women(p=0.0001).Tobacco products except cigarette were mostly used by men, people younger than
the age of 35 and with high educational level.The smoke cessation percentage of women was statistically significantly higher than men(p=0.006).70.7% of active
smokers were thinking about quitting, but only 12,8% of participants who tried to quit had admitted cessation therapy;scientific methods were chosen in 53.8.
93.9% of active smokers were using cigarette at homes.Non-smokers were exposed to second hand smoke(SHS) at homes(34.1%),vehicles(14,9%) and work
places(14,4%).Participants having children younger than 18 age were using tobacco products at home with the percantage of 42.6%. 98% of all participants
were aware of the law and 91.5% of them were supporting it.The law support of women(95,3%) was statistically significantly higher than men(88.5%;p=0.002).
42% of participants who succeeded in quitting had managed it after the ban;and 36,6% of active smokers started to think about quitting.The state of quitting andreducing smoking was higher in women and people with low nicotine dependence level(NDL).Restriction of areas, rise of prices and effects of SHS were themost popular reasons of reducing or quitting smoking after the law.The number of cigarettes smoking in one day was reduced by 3.19 cigarettes/day.The rate ofviolation of the ban was 32,3% (higher in men and people with high NDL).96,4% of supporters of the law was finding law successful and sufficient.
CONCLUSION:The frequency of smoking was higher than Turkey’s average in İzmir.The mean age of starting smoking was below 18.Use of tobacco products
except cigarette may be an emerging problem particularly in youngers.A big amount of participants thinks about quitting, and the law is thought to have important
effect on this decision.The ban seems to have more effects in women.Second hand smoke has reduced mostly in public areas with ban, but law must be enlarged
to prevent SHS at private areas such as houses,vehicles and workplaces.As a result; the ban encouraged smokers to quit and reduced SHS at public areas.

79S2-01The Effects of Weight Control Perception on Quitting and Cigarette Consumption: Findings from the ITC Project

Ce SHANG1, Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Mary THOMPSON2, Mohammad SIAHPUSH4
University of Illinois at Chicago1, University of Waterloo2, Ontario Institute for Cancer Research3, University of Nebraska Medical Center4
Studies using the U.S data have shown that girls may initiate smoking in response to a weight gain and women may be less price responsive than men in reducing
smoking. However, there is lack of research on if and how the idea of smoking as a mean of weight control might influence quitting and cigarette consumption.
In particular, the idea itself, instead of an actual weight gain or a change of body image, may directly impact quitting and cigarette consumption. On the other
hand, the perception of smoking as a mean of weight control may or may not be prevalent in some countries. Therefore, it is necessary to understand the above
questions through empirical analysis. Using data taken from eight countries of the International Tobacco Control Policy Evaluation Project surveys, this paper
provides the first empirical evidence on the explicit measure of weight control perception of smoking and its impact on quitting and cigarette consumption. We
also test if the interest impact varies by countries with different opinions on the weight control effect of smoking. After accounting for individual heterogeneity insmoking behaviors, our results show that agreeing on the weight control effect of smoking is associated with more cigarette consumption. In addition, the results
suggest that the impact of weight control perception on quitting and quit attempts varies by country. Nonetheless, in most countries, weight control perception issignificantly associated with either less quitting or fewer quit attempts.

S2-02

Mortality Risks of COPD for Nonsmokers and Smokers from a Prospective Cohort Study of 390,269 Subjects in TaiwanAssessing Involvement beyond the Lungs

Chi-Pang WEN, Wei-Erh CHENG, Min-Kuang TSAI, Shiuan Be WU
National Health Research Institutes, China Medical University Hospital
Background and aims: COPD is known to increase mortality in respiratory diseases, but is less known for its extra-pulmonary and lung cancer effect, particularly
among nonsmokers. To assess the risks of COPD subjects among smokers and nonsmokers and to quantify its mortality effect beyond the lungs.
Methods: The cohort consisted of 390,269 adults, between 1994 and 2008, went througha fee-for-service, standard panel of health screening program. COPD was defined byGold criteria. Mortality and cancer incidence were identified in an average of 8.5 years offollow-up. Cox proportionate model was used to calculate the hazard ratios (HR).
Results: More men (4.6%) than women (3.8%) and more smokers (5.3%) than nonsmokers(3.7%) had COPD, with a mean age of 50. Not only smokers (4.5-fold) but also nonsmokers(1.4-fold) had lung cancer mortality significantly increased, implying the independent
effect from COPD. Other than lung cancer and respiratory diseases, COPD had increased
risks for CVD (HR: 1.76; 1.46-2.13), including ischemic heart disease (HR: 1.63; 1.122.37) and stroke (HR: 1.80; 1.34-2.43), and kidney diseases (HR: 2.32; 1.43-3.75). The
extra-pulmonary causes constituted 77% for non-smokers and 58% for smokers.
Conclusions: Three quarters of the excess deaths among nonsmoking and more thanhalf of smoking COPD subjects died from causes beyond the lungs. They had systemic
involvement with increases in stroke, heart, renal and infectious diseases, in addition tolung cancer. These extra-pulmonary risks, under-appreciated by clinicians and unaware ofby the patients, are major challenges to overcome.

S2-03

Early Detection and Treatment of COPD Can Be Made by Tobacco Cessation Clinic

Junji MORITA1,2, Kohichi KIMURA1, Katashi SATOH3, Risa YAMAGAMI1
Kimura Chest Clinic1, Matsubara Hospital2, Kagawa Prefectural Health Sciences3
Extreme increase of COPD patients will become very serious social problem in the near future. Many investigator worry about that in 2040, Japan will have thepeak of increasing curve of COPD. In order to put down this peak lower, we should try to detect COPD earlier as possible. But it is very difficult to detect earlystage of COPD patient, because they usually don’t have subjective symptoms.
In our tobacco cessation clinic, we have more than 100 new patients. Among these patients, from 2010 we examine spirometry against heavy smoker or over 50th.
And if they revealed obstructive disorder, we have taken thin slice CT scan. More than 30 cases have been diagnosed as COPD without subjective symptom. The
result of CT scan displayed by OsiriX(powerful DICOM viewer), which make image easier to understand for every patients.
We believe tobacco cessation clinic can be the gate for early detection and treatment of COPD. At the same time, every practitioners should have pay attention
to every smokers who might have early COPD.

80

S2-04

Relationship between Respiratory Diseases of Schoolchildren and Tobacco Smoke in Hong Kong and Sri Lanka

S. H. LEE, W. T. HUNG
The Hong Kong Polytechnic University
Public concern over health effects of the indoor environment has arisen. Interest has mainly been focused on the potential hazards of tobacco smoke. Numerous
researchers have found that there is a correlation between the concentration of air pollutants and the decline of pulmonary function in children. As children are
more sensitive to the air pollution effects, therefore many studies focused on the respiratory impacts on children. This study intends to compare the pulmonary
function as well as the living environment of schoolchildren between Hong Kong and Sri Lanka.
The study involves selecting primary five or six students (age 11-12) from schools in Hong Kong and Sri Lanka. A respiratory health questionnaire wasdistributed through the schools to students; information was collected by a parent-completed questionnaire. The questionnaire is divided into 2 sections. Section
A is used to obtain some indoor environment conditions such as tobacco smoke. Section B is used to ascertain lifetime prevalence of asthma, wheeze as well as
the child’s respiratory health during the last 12 months. Each sampled student was also required to conduct a pulmonary function test.
A total of 240 students coming from Hong Kong and 109 students coming from Sri Lanka were sampled. After collecting the questionnaires and performing thepulmonary function test, a statistical t-test and correlation were carried out. By statistical analysis, we have found that students’ have smokers as family members
has a significantly lower pulmonary function in mean than those without smokers at home in both Sri Lanka and Hong Kong. Furthermore, the medical histories
such as bronchitis, asthma, pneumonia, etc were recorded. High correlation were recorded between respiratory diseases of schoolchildren and the number ofcigarettes that being smoked per day by the smoking family member.
Keyword: Pulmonary function test; Spirometry; Indoor Environment; Respiratory health

S2-05

Examination about the Usefulness of Hi-checker in Smoking Outpatients

Naoto WATANABE1,2, Keigo SASAKI2, Kazunori ARAI1, Sohei MAKINO1Tokyo Allergic and Respiratory Disease Institute1, Sasaki Hospital2Aim) We investigated the detection rate of COPD by Hi-checker in the smoking patients, and examined usefulness of Hi-checker.
Subjects) Eighty-four outpatients (Mean age:48y, M:59, F:25) of smoking cessation clinic
Methods) COPD were detected by the pulmonary function test using both Hi-checker and Spirometer.
Results) FEV1/FEV6% by Hi-checker was correlated with FEV1% by Spirometer. There was also an interrelation between FEV1% and %V50 or %V25.
Moreover, FEV1 and smoking period were correlated.
Twenty-eight patients were FEV1/FEV6<0.75 and 13 patients of them were FEV1%<70%. There were 11 patients with COPD and 2 patients with bronchialasthma in 13 patients with obstructive pulmonary impairment.
Nine of 11 patients with COPD were B.I>400.
Consideration) Hi-checker was useful as screening inspection of COPD, however it was necessary for diagnosis of COPD to check the obstructive pulmonary
disorder by Spirometer and the bronchial reversibility.
Moreover, it was suggested that airway obstruction advanced according to the long smoking period.

S2-06
Hajime KUROSAWA
Tohoku University81S3-01

Smoking and Oral Health

Tetsunori OZAKI
Nihon University
In spite of having performed smoking through the mouth, the concern about the health of smoking and an oral area was low in dentistry, before. Not only anaverage citizen but the dentist and the dental hygienist of the lowness of concern were the same.
Therefore, that it was behind compared with examination of a medical department cannot deny the examination about the relevance of smoking and a dental
problem.
However, the report that smoking is big risk-factors, such as periodontosis, oral cancer, mouth odor halitosis, dental caries and coloring to the restoration materialof a tooth, gingiva and a tooth, in the field of dentistry is increased in recent years.
The oral disease such as periodontal disease and dental caries has a high prevalence rate of a disease with lifestyles and relation, and many of other dental
problems relate to these two diseases.
In the field of dentistry, there was a tendency for the research and the measure against the oral bacteria which are the main factor of periodontal disease anddental caries to have been made preponderantly. That is, as a measure against the oral diseases, it is the plaque control represented by tooth brushing and usingof fluoride.
However, it has come to have a new appreciation of relation of smoking and an oral disease being larger in recent years, from examination of the influence which
the various substances in tobacco smoke have on tooth, periodontal tissue, oral mucosa, etc. directly or indirectly.
In the health disturbance in the field of dentistry, periodontosis is representation quantitatively (prevalence rate in an adult is high) and oral cancer is a
representative case qualitatively (not only the crisis of a life but QOL falls greatly).
In addition, although much health disturbance is mentioned, the outline of the oral disease considered in relevance with smoking is presented here.

S3-02

Development of Oral Lesion Screening Clinic in Hospital Dental Department

Piyada PRASERTSOM1, Sutha JIENMANE-CHOTCHAI1, Siripen ARUNPRAPHAN2, Woranut WEERAPRADIST3, Somjin CHINDAVIJAK4
Ministry of Public Health1, Thai Dentist against Tobacco Project2, Mahidol University3, National Cancer Institute4
Background: The information derived from the National Cancer Institute indicated that the Age-standardized incidence rate (ASR) for the oral cancer ofThailand in 2006 were 4.8 and 3.6 per in male and females. Moreover, the Meta analysis conducted by the International Health Policy Program, Thailand
revealed that smokers were facing 2.66 times higher risk from the oral cancer than nonsmokers. Early detection of the oral cancer would lead to greater chancesof successful treatment and increase a 5-year survival rate.
Purpose: To develop the oral lesion screening system and oral cancer care in the Dental department.
Method: The development of the screening system was designed in 5 steps: 1). Study to assess risks to oral cancer. 2). Development of manual and guideline toscreen and manage oral lesion. 3). Establishment of demonstration oral lesion screening unit 4). Knowledge management and sharing 5). Implementation in thehealth system. Statistical analysis was used according to characteristics of data. Level of confidence was set at 95%. Study duration was 2004-2010.
Results: In 2004, the risk assessment study showed that smoking behavior, drinking alcohol and betel nut chewing were the significant factors among 98 oral
cancer patients of the National Cancer Institute and Lopburi Cancer Hospital (p<0.05). 39.5%-77.8% of the patients were smokers and alcohol drinkers. 80%
chewed betel nut. The oral lesion screening manual was constructed which consists of oral health examination and interviewing forms. After that the manual
was tested and intervened in 4 provinces. Results showed significant higher rate of oral precancerous lesion detection. There was 0.8% compare to 4:100,00 innormal report system. The oral lesion unit in the dental clinic of the community hospitals were set up. The project was expanded to 12 provinces 36 community
hospital which objected to set the oral lesion and smoking cessation unit in the dental department.
Conclusion: The study showed significant benefit of oral precancerous screening system. After 3 years, the project proposed the oral cancer screening as a basic
package to the office of Health Security Fund for people aged 40 and over. Nowadays oral cancer screening is a basic health benefit of Thais.

S3-03

Novel Curriculum of Smoking Cessation for Dental Students

Takashi HANIOKA
Fukuoka Dental College
Background and aim. Dental professionals have not fully embraced opportunities for tobacco intervention. The aim of my presentation is to suggest new strategy
of curriculum to enhance smoking cessation intervention based on the novel findings that may useful under the universal health insurance system in Japan.
Methods. We reviewed literatures regarding tobacco interventions by dental professionals and recent studies regarding oral microbiology, and surveyed dentists
and dental patients to clarify the possibility of our strategy.
Results. The literature review regarding progression of the global dental tobacco interventions identified significant barriers such as lack of reimbursement andtraining for implementation to dental practice and dissemination and undergraduate education. Recent findings regarding the effects of smoking cessation onoral biofilms and those of tobacco extracts on virulence factor of periodontal pathogens would break the ice to enforce dental tobacco intervention in Japan. The
studies that was conducted in dental clinics revealed that tobacco intervention for prevention of progression of dental disease and improvement of the effects ofdental treatments that have potential coverage of the universal health insurance system in Japan were strongly supported by dentists while intervention services
for prevention of oral diseases was strongly supported by dental patients.
Conclusion. Education for dental students regarding tobacco intervention based on the effects on dental treatments would be promising strategy that reinforces
those for oral and overall health in Japan.

82

S3-04The Attitude Survey of Smoking Associated with Periodontal and Peri-implant Disease

Ken YUKAWA, Motohiro MUNAKATA, Noriko TACHIKAWA, Shohei KASUGAITokyo Medical and Dental University
PurposeThere are a lots study associated smoking with periodontal and peri-implant disease, however, no report published about the psychological crisis of smoking
with periodontal and peri-implant disease. The aim of this study was to investigate the patient’s attitude of smoking and the risk factor for periodontal and periimplant disease.
Methods
Objects were 1159 new patients who visited the clinic for oral implant Tokyo Medical and Dental University Hospital from January 2012 to December 2012.
The methodology was a questionnaire-survey about Kano Test for Social Nicotine Dependence (KTSND), smoking status and the knowledge of the risk factor
about periodontal and peri-implant disease.
Result
The value of KTSND was 9.7±4.9. There were 624 patients (53%) who didn’t know smoking was a risk factor for periodontal disease. There were 236 patients(20%) who didn’t know smoking was a risk factor for peri-implant disease. There were 144 patients (12%) who smoke and 216 patients (19%) who have given
up smoking. The value of KTSND with patients smoke was 11.8±4.0, with patients have given up smoking was 9.6±4.5 and with non-smoker was 9.3±5.1. There
were significant differences, between smoker and patients have given up smoking, and smoker and non-smoker.
Discussion and Conclusion
This study showed the patients know smoking was risk factor for peri-implant disease was only 20%. Because implant treatment recently has boiled over injapan, the doctor who treat the implant therapy and patients who treated didn’t recognized sufficiently the informed consent like the pain after operation, thenecessity of maintenance and the risk factor of survival rate. Additionally the value of KTSND was relatively low; patients had high awareness of systemic
effects of smoking. Therefore the patients could understand and practice tobacco prevention by explaining the sufficient informed consent of implant therapy.

S3-05

Characteristic of Dental Care Received by Smokers in Japan

Miki OJIMA , Takashi HANIOKA2
Osaka University1, Fukuoka Dental College2
1

Objectives: Although epidemiological studies have demonstrated that smokers more frequently have dental disease, compared with non-smokers, it is unclear
whether a difference in dental care between smokers and non-smokers exists. We investigated smoking status and treated disease among dental patients throughout
Japan to evaluate the characteristics of dental care received by smokers.
Subjects and Methods: Questionnaires were mailed to 1022 dentists who were randomly selected from members of the Japanese Dental Association. Dentists
were instructed to record one treated disease or encounter with patients that was principally responsible for specific dental care on the day of the survey. Patientswere classified into groups receiving gingival/periodontal treatment (GPT), caries/endodontic treatment (CET), prosthetic treatment (PRT), periodical check-up/
orthodontic treatment (POT) and other encounters/treatments (OET). Distribution of the five groups was compared for smoking status. In accordance with thelevel of progression of treated disease, the GPT and CET were further divided into two subgroups. Logistic regression models were constructed for analysis of
the GPT and CET subpopulations, adjusting for gender and/or age.
Results: The response rate was 73.7%. After excluding former smokers, the data of 2835 current smokers and 6850 non-smokers from 753 clinics were analysed.
The overall distribution of the five groups significantly differed by smoking (P = 0.001). The ad hoc test for each group showed significant difference in CET (P =0.002) and POT (P = 0.001) by smoking, with current smokers more likely received CET than non-smokers and less likely to receive POT, though the differenceswere relatively small (47.1% vs. 43.6% and 1.6% vs. 2.7%, respectively). In contrast, proportions of GPT, PRT and OET was almost equivalent between nonsmokers and current smokers (28.8% vs. 27.7%, 20.3% vs. 19.0%, and 4.6% vs. 4.7%, respectively). current smokers more likely received GPT for advanced
stage disease in the age groups of 40-59 years and ≥60 years (OR=1.67[1.10-2.56], P=0.019 and 2.25[1.62-3.11], P<0.001, respectively), and CET for advanced
stage disease (OR =1.39[1.19-1.62]; P<0.001) than non-smokers.
Conclusions: These results indicate that current smokers receive less preventive and more intensive dental care than do non-smokers, suggesting that smoking
increases dental care expenses in smokers.

S3-06

Physiological Metals in the Serum, Hair and Nails of Patients with Head and Neck Cancer

Anna M. WOZNIAK1, Maksymilian J. KULZA1, Monika A. SENCZUK-PRZYBYLOWSKA1, Anita KUJAWA1, Wojciech GOLUSINSKI2,
Krzysztof SZYFTER1,3, Wojciech PIEKOSZEWSKI4, Witold SZYFTER1, Ewa K. FLOREK1
Poznan University1, Greater Poland Cancer Centre2, Institute of Human Genetics3, Poznan Jagiellonian University4
Head and neck cancers represent nowadays 12% of all malignant tumors. The highest number of cases is reported for East Asia, Central and Southern Europe.
A strong correlation between certain risk factors and the frequency of their occurrence has been proven (tobacco smoking, drinking strong alcohol, lack of
micronutrients, HPV infection).
The aim of the study was calcium, magnesium, copper, iron, zinc and manganese levels evaluation in different types of biological material in patients with tumorsof the larynx, salivary glands, oral cavity and tongue. Alternative material was used (hair, nails) in relation to serum samples to assess exposure to sources ofendogenous metals. The impact of tobacco smoking, strong alcohol drinking and type of diet was considered. The study group comprised 41 men, 18 womencancer patients of Otolaryngology and Laryngological Oncology Clinic of Poznan University of Medical Sciences, Poland and the Head and Neck Surgery Wardof the Greater Poland Cancer Centre, Poznan. The control group consisted of 9 men, 11 women, patients of those Hospitals. An original method of questionnaire
was used for the study. Hair and nail samples have been subjected to an appropriate washing and drying procedure. Alternative materials and serum haveunderwent the process of digestion. The next step was quantitative analysis using ISP-MS method. In order to obtain more useful information ChemometricAnalysis in a multidimensional data set was used. Significant strong correlation between tobacco smoking while alcohol drinking and between exclusively
tobacco smoking and appearance of cancer was shown. A higher frequency of larynx, salivary gland, oral cavity and tongue cancer was demonstrated when there
was a deficiency of fiber and grain products in a diet. There was a higher concentration of calcium, magnesium, iron and manganese in hair and nails of patientswith salivary gland cancer. According to applied Chemometric Analysis of Principal Component 1 it was shown, that the variables identified in the nails – theconcentration of iron, copper, manganese with magnesium and zinc are strongly correlated. In hair samples decreased correlation level between variables wasshown – concentrations of calcium and magnesium as well as iron and manganese were highlighted as two groups of variables correlated.
Has not been shown which alternative material – hair/nails, in relation to blood serum, is better to determine the level of physiological metals in laryngeal,
salivary glands, oral cavity and tongue cancer patients. Further research is required.
A research project funded by the NCN 2011/03/N/NZ7/06266

83

Despite the fact that the dose of smoke delivered to active smokers is
100 times or more that of second-hand smoke delivered passively, therelative risk of coronary heart disease for active smokers is 1.78,
compared with 1.31 for nonsmokers exposed to second-hand smoke.

S4-01

Smoking and Heart Diseases

Akiyoshi OGIMOTO, Jitsuo HIGAKI
Ehime University

Enthusiastic and persistent efforts should be made to encourage
individuals not to smoke to prevent and treat smoking-induced
complications, especially before the development of serious diseases
that wear away happiness and increase medical expenditures.

Smoking causes 5 million deaths per year worldwide and is regarded as one of the major causes of premature death. If present trends continue, in 2025, the death
Figurerate due to smoking is projected to be 10 million individuals per year. Smoking has a considerable
negative effect on cardiovascular disease (CVD) and all-cause
mortality in Japan. Data from NIPPON DATA80 showed that the population-attributablerisk fraction (PAF) of CVD mortality due to smoking was 27.5% for men and 5.0% forwomen, while the PAF of all-cause mortality was 15.0% for men and 4.0% for women. In
fact, the life expectancy of a heavy smoker is reported to be a little more than seven years
shorter than that of a never smoker. Smoking also reduces the expected lifetime in self-rated
good health or without longstanding illness and increases the number of remaining lifeyears in poor health. Recently, exposure to second-hand smoke has been shown to increase
the risk of many diseases. In particular, it is capable of precipitating acute manifestationsof CVD, and it may also have a negative impact on the outcome of patients with CVD.
Despite the fact that the dose of smoke delivered to active smokers is 100 times or more thatof second-hand smoke delivered passively, the relative risk of coronary heart disease foractive smokers is 1.78, compared with 1.31 for nonsmokers exposed to second-hand smoke.
Enthusiastic and persistent efforts should be made to encourage individuals not to smoke
to prevent and treat smoking-induced complications, especially before the development ofserious diseases that wear away happiness and increase medical expenditures.

S4-02

Smoking and Heart Diseases

Kazunori SHIMADA, Hiroyuki DAIDA
Juntendo University

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Cardiovascular disease is the leading cause of death worldwide. Smoking is one of the major risk factors contributing to morbidity and mortality of cardiovasculardiseases, including coronary artery disease (CAD), stroke, and peripheral artery disease. Indeed, major epidemiological studies have demonstrated the relation
between cigarette smoking and CAD mortality, and that smoking cessation reduces mortality from CAD. There are several pathogenic mechanisms proposed
to explain the harmful effects of smoking on CAD, such as stimulation of the sympathetic nerve system, vasoconstriction, endothelial injury, and dyslipidemia.
Smoking increases the risk of impaired glucose tolerance, the incidence of type 2 diabetes and abdominal obesity. Recent data have demonstrated that smokers
have higher waist circumferences and risk factors for CAD. Smoking may lead not only cardiovascular disorders, but also metabolic risk factors. We havepreviously reported an association between adipocyte derived plasma protein, adiponectin, and smoking status in patients with CAD. In this study, plasma
concentrations of adiponectin were associated with smoking status in patients with CAD regardless of their body mass index and insulin resistance. One possible
mechanism by which smoking could lead to decreased circulating adiponectin concentrations is via an increase in the activity of the sympathetic nervous systemsecondary to the effects of nicotine to activate post-ganglionic sympathetic nerves. Another mechanism might be the consumption of circulating adiponectin in
injured vessels damaged by smoking and/or components of smoking. Adiponectin has binding ability to collagens I, III, and V, and accumulates in the injured
vascular walls. Therefore, decreased adiponectin caused by smoking may play an important role in the pathophysiology of CAD.
In this Symposium, we will summarize the recent data regarding with the impact of smoking habit of the morbidity and mortality of CAD, and discuss the effectsof smoking cessation on the morbidity and mortality of CAD.

S4-03

Mechanism of Cigarette Smoke Extract-Induced Reorganization of the Actin Cytoskeleton in Human Endothelial Cells

Bo-Hong LIN, Tsu-Shing WANG
Chung Shan Medical University
Cigarette smoking is a major cause of cardiovascular disorders. Actin cytoskeleton is a possible key player in responding to inflammatory stimuli and also an
early target of cellular oxidative stress. Laboratory previous results also show that cigarette smoke extract (CSE) induces rapid actin cytoskeleton remodelingand up-regulate ICAM-1 (intercellular adhesion molecule-1) expression in human umbilical vein endothelial cells (HUVEC). The purpose of this study is tounderstand the actin damages and its possible mechanism in human umbilical vein endothelial cells EA.hy926 exposed to cigarette smoke extract (CSE). The
results showed that CSE caused dose- and time-dependent reorganization of actin cytoskeleton and cell shrinkage in EA.hy926 cells by staining with rhodamine
phalloidin. In addition, CSE increased total protein carbonylation in a dose-dependent manner. Cells co-treated with different chemical compounds, such asreactive oxygen species scavenger (vitamin C, alpha-tocopherol, lipoic acid, glutathione, N-acetylcysteine), reactive carbonyl scavengers (aminoguanidine),
calcium chelator (ethylene glycol tetraacetic acid, BAPTA-AM ), transient receptor potential cation channels inhibitor (MRS 1845), and autopgay inhibitor(3-methyladenine) with CSE caused different inhibition of actin reorganization, protein carbonylation, and cell shrinkage in CSE-treated EA.hy926 cells. Amongthese compounds, lipoic acid, glutathione, EGTA, and MRS 1845 were found to potently inhibit the CSE-induced actin cytoskeleton reorganization and cell
shrinkage. Furthermore, immunofluorescence staining analysis showed that the autophagy marker LC3 protein (microtubule-associated protein 1 light chain 3)
accumulated at cell cortex in CSE-treated cells. Collectively, these findings suggest that CSE-mediated ROS generation and Ca2+ influx increase through TRPC
channels are the key factors that may cause reorganization of actin cytoskeleton and the subsequent cell shrinkage. In addition, CSE-induced inappropriateorganization of the actin cytoskeleton may dysregulate autophagy by abnormal accumulation of LC3 proteins at cell cortex.

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S4-04

Relationship between Nicotine Dependence and Carotid Arterial Stiffness in 4,130 Chinese Male Smokers

Dan XIAO1,2, Chunmei ZHANG1,2, Ruijun GUO1, Zhi’an LI3, Wenli CHEN1,2, Chen WANG2,4, Pintong HUANG5, Lin MA6
Beijing Chao-Yang Hospital1, World Health Organization Collaboration Center for Tobacco or Health in China2, Beijing An-Zhen Hospital3, Beijing Hospital,
Ministry of Health4, The Second affiliated Hospital of Zhejiang University School of Medicine5, Hebei United University Affiliated Hospital6
Correspondence to: Zhi’an Li, Beijing An-Zhen Hospital Affiliated to Capital Medical University, Beijing 100029, China.
Objective This study analyses the relationship between nicotine dependence and carotid arterial stiffness in a sample of smokers from the general population.
Methods We conducted a study (2009-2011) of a representative sample of the general population from 46 hospitals in China (n=4,719). The analysis included
4,130 daily smokers aged more than 16 years. Nicotine dependence was measured by three ways: 1) the Fagerström Test for Nicotine Dependence (FTND); 2)
the time to the first cigarette of the day; and 3) the time to the first cigarette of the day and number of cigarettes per day. Information on smoking was obtainedby questionnaire and arterial stiffness was determined by B ultrasound.
Results Participants smoked a mean of 17.0 cigarettes per day, and the mean FTND score was 3.30 (95% confidence interval: 3.21, 3.36). Around 11% of subjects
had high nicotine dependence. Carotid arterial stiffness differed significantly by nicotine dependence levels.
Conclusion Carotid arterial stiffness levels were associated with nicotine dependence as measured by the FTND, especially with the items on daily tobacco
consumption and time to first cigarette after waking up.
Key words: Common Carotid artery; Nicotine dependence; Arterial stiffness; E-tracking technique

S4-05

The Effect of Second Hand Smoker on High Molecular Weight Adiponectin Levels in Adults Women: A Preliminary
ReportSiti H. MOHD HANAFFI, Harmy MOHAMAD YUSOFF, Norhayati MOHD NOOR, Aida H. GHULAM RASOOL, Hamid J. JAN MOHAMAD
Universiti Sains Malaysia
Introduction: Second hand smoker (SHS) is defined as a person who frequently exposed to cigarette smoke. Epidemiology studies have evidently reported
the effect of second-hand smoker on cardiovascular events. Adiponectin play an important role in regulation of insulin-sensitivity, lipid metabolism, antiinflammatory and anti-atherogenic properties. Previous studies suggested that high molecular weight (HMW) adiponectin is better than total adiponectin as
predictor of cardiovascular disease (CVD). A low adiponectin (hypoadiponectinemia) concentration was observed among active smoker but lack of data on
second hand smokers.
Objectives: This study aim to compare serum high molecular weight adiponectin levels between second hand smokers and non second hand smokers in total
125 healthy female adults.
Method: A comparative cross-sectional study was carried out in May 2011 until December 2013. Subjects was identified and assigned into two groups. Second
hand smoker was defined as person who exposed to cigarette smoke for more than 15 minutes in two day in a week. While, those are free from cigarette smoke
used as control. Sixty six were categorised into the group of second hand smokers, while fifty nine were categorised to the group of control. Serum highmolecular weight adiponectin was measured in both groups.
Results: Mean ± SD age of subjects in this study was 33.2 ± 8.27. Mean serum HMW adiponectin levels (µg/mL) in the second hand smokers and control was
3.7 ± 2.92 and 4.9 ± 3.73 respectively, p = 0.053. However, a significant reduction in serum HMW adiponectin in second hand smokers compared to controls
after controlling of age, blood pressure, low density lipoprotein (LDL) and triglycerides cholesterol [ 3.7 (2.89, 4.44) vs. 5.0 (4.17, 5.82) respectively, p = 0.022].
Conclusion: High molecular weight adiponectin has potential use for early detection on cardiovascular disease risk among second hand smokers.

S4-06
Dong Jin OH
Kong Dong Sacred Heart Hospital, Hallym University85

S5-01

Current Situation of Second-hand Smoke in Japan

S5-02

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Japanese government implemented Health Promotion Act in 2003 that requires
the managers of all the facilities where many people gather to take effective
measures to protect non-smokers from second-hand smoke (SHS). However,require is not mandatory and the use of smoking rooms or separation ofsmoking areas are thought to be effective measures. As a result, Japan has beena signatory to the WHO Framework Convention on Tobacco Control since2004, many people are still exposed to SHS in public places and workplaces
including hospitality industries. We have been measuring the exposure levelsof SHS in terms of the concentration of particlulate matter smaller than 2.5
micrometer in diameter (PM2.5). As shown in figure, the concentrations of SHS
in the smoking section of café reach 500 ~ 800 ug/m3 that are more than 20 ~30 times higher than the safety level shown by WHO Air quality guidelines andthose levels are thought to be “Dangerous” according to the EPA Air quality
index. Even non-smoking sections are also contaminated from the diffusionof tobacco smoke from smoking sections showing the concentrations that areequivalent to “Moderate” or “Unhealthy” level of EPA Air quality index. Totalban on smoking including hospitality industries as required by FCTC Article
8 has to be implemented in order to protect all the workers and customers toprotect from the exposure to SHS in Japan.

Particulate Matter 2.5 （μg/m3）

Hiroshi YAMATO
University of Environmental HealthFig. Second-hand smoke concentration in smoking section andnon-smoking section in café

Korea’s Steps toward Smoke-free Workplace and Public Space

Eun Ji KIM
Korean Association on Smoking or Health, Ajou University School of Medicine
Since 1990’s Korea government tried to reduce effects of tobacco smoking in public space enacting Health Promotion Act. In 1995 Health Promotion Act
prohibited smoking in some public spaces like hospitals, hotels, big buildings including workplace, and big theaters. But those facilities were not fully designatedas smoke-free facilities but some part of that facilities were designated as smoke-free area. After that schools were included smoke-free facilities.
In 2003, smoke-free areas expanded to 16 types of facilities in Korea. Public baths, big restaurants, big public building and kindergartens were newly enlisted tosmoke-free facilities at that time. In case of school buildings, hospital facilities and kindergartens, whole spaces were designated as a smoke-free area. But almost
people working at buildings were not protected from tobacco smoke in Korea.
Recently Korea’s situation has changed because Health Promotion Act was revised and smoke-free zone has enlarged to 26 types of facilities in 2011. In thislist you can see highway service stations and cars carrying children. Now people using big restaurants are not allowed to smoke there and all people in schools
including school buildings and playgrounds do not smoke there, too. More over in 2015, all restaurants in Korea will be smoke-free area and whoever use
restaurants do not smoke there.
Korean people still want more and Korea government is trying to step forward. Much more people want to be protected from tobacco smoke in Korea and every
workplace and building has to be smoke-free area in the near future.

S5-03

Multiple Chemical Sensitivity due to Passive Smoking: a Unique Japanese Syndrome?

Michiyuki MATSUZAKI
Fukagawa City Hospital
Although “multiple chemical sensitivity (MCS)” may not be approved as a definite disease entity in other countries, many Japanese people suffer MCS after
passive tobacco smoke exposure at workplace. As a medical doctor, I have treated six MCS cases (4 males and 2 females,35 years-old in average ) due to passive
smoking, and helped their law suits for relief and compensation.
Diagnosis of MSC followed tentative diagnosis criterion for chemical sensitivity proposed by the working group on allergic diseases funded by Department of
Health and Welfare of Japan in 1997.
Before the onset of MCS, all of them have no history of active smoking, or any particular mental or allergic disorders. Their workplaces were not 100% smokefree. Five developed MCS after chronic exposure for weeks or months, and one after a sudden high exposure in a car during work. They experienced headache,dizziness, nausea, cough, runny nose, runny eye, wheals, general fatigue or palpitation soon after tobacco smoke exposure. Symptoms diminished or disappeared
after going home, but relapsed visiting workplace next day. As the degree of MCS symptom was too severe to continue working there for all of them, most ofthem had to resign or take a long leave. To make things worse, all of them felt very bad soon after the exposure to other substance such as car exhaust, cooking
smoke, perfumes, anti-odorants or third hand smoke.
All of them sued their employer (four private sector and two local government). Four won the case getting 700~100,000 dollars for compensation. But most ofthem had to leave the job because their health status did not recover sufficiently even after long discontinuation of passive smoking.
MCS victims due to workplace passive smoking represent the fault of Japanese government that has not implemented 100% smoke-free law.
I propose that MCS should be added to the list of disorders due to passive smoking.

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S5-04

Smoking on the Margins: An Equity Analysis of Vancouver's Outdoor Smoke-free Policy in Parks and on Beaches

Chizimuzo T. OKOLI1, Ann PEDERSON2, Wendy M. RICE2
University of Kentucky1, British Columbia Centre of Excellence for Women's Health2
Background: Increasingly, jurisdictions worldwide are implementing smoking restrictions in outdoor public spaces to reduce secondhand smoke exposure,
discourage youth initiation, enhance cessation, and reduce environmental hazards (i.e., fire and cigarette-related litter). However, there is little research on thepolicy context and health-equity impact of such policies to help guide wider implementation efforts. Objectives: On September 1, 2010, the Board of Parks andRecreation in Vancouver, Canada, introduced a smoke-free bylaw for the city’s parks and beaches. The Smoking on the Margins project is examining the policy
context and potential health-equity impact of this bylaw. Methods: Applying critical multiplism and equity-focused health impact assessment frameworks,
mixed-methods research was used to describe the context and examine health-equity impacts of the bylaw through seven sub-projects. Preliminary Results:
Sub-project 1: An observation study (N=6 parks/beaches) found significant reductions in the overall observed smoking rates in selected parks/beaches fromprelaw (mean rate=20.5/1000 persons) to 12-months post-law (mean rate=4.7/1000 persons). .
Sub-Project 2: A population telephone-survey (N=500 participants) found that 84% of Vancouver residents endorsed the bylaw; smokers were significantly lesslikely to do so.
Sub-project 3: Two enforcement officer focus-group interviews (n=6 officers/focus-group) found that enforcement practices varied on the basis of park/beachsetting, usage patterns, and the likelihood of users to comply. Marginalized populations of smokers were somewhat less likely to be fined for violating the bylaw.
Sub-project 4: Key informant interviews in the cities of Vancouver (n=8), Kelowna (n=5), and Surrey (n=4) found that health, environmental and social concerns
are common to all jurisdictions considering implementing an outdoor smoke-free policy but to different degrees.
Sub-project 5: A print-media study (N=90 articles/letters, retrieved Jan2010 to Dec2011) found that in relation to article slant, 38.9% had positive coverage ofthe bylaw, 30% were neutral, 22.2% were negative. News articles were more likely to be positive, letters to be negative.
Sub-project 6: A beach-litter study (N=48 beaches/parks) found non-significant changes in cigarette-related litter between 2010 (mean=1018.7 cigarette-butts/
filters) and 2011 (mean=919.6 cigarette-butts/filters).
Sub-project 7: A by-law citations study (Jan2011-Dec2011) indicates that citations were issued more frequently at beaches (n=26) than parks (n=12).
Conclusion: Our data suggest that though the outdoor smoke-free policy had strong support in Vancouver, it also had differential effects for park and beachusers. Understanding the impact of the policy on diverse groups can minimize potential unintended consequences of outdoor smoke-free policies while providing
directions and considerations to help make similar policies more equitable.

S5-05

Smoke-free Tourism: Wave of the Future:

Domilyn VILLARREIZSoutheast Asia Tobacco Control Alliance, Framework Convention Alliance
Tourism is vital for many countries, and many tourist destinations are often exempted from “No Smoking” policies out of fear that the influx of tourists willdiminish if smoking is banned in public places. Nevertheless, tourists should be protected from exposure to secondhand smoke, and these places should beprotected from fires due to cigarette smoking and pollution by cigarette litter.
The WHO-Framework Convention on Tobacco Control (FCTC) Article 8 Guidelines encourage governments to protect all people from exposure to tobaccosmoke in all indoor workplaces, indoor public places, and as appropriate other public places through strict enforcement of good smoke-free legislation. The
Article 8 guidelines do not have a strict definition for public places, so most local governments allow smoking in many tourist attractions.
The Smoke-free Tourism concept recognizes the many complex interconnections between existing tourism settings and health risks. This concept also recognizes
that making indoor places and public places smoke-free can attract a lot of tourists making them popular smoke-free tourist destinations. Several UNESCO World
Heritage sites like Luang Prabang, Halong, Sukothai, and Malacca are smoke-free; Davao in the Philippines is one of the cities which promotes smoke-free
tourism, including at its high-earning casino; and hotels, restaurants, and public parks are promoting this campaign as well.
The presentations of smoke-free tourist destinations will consider the health, social and economic impacts of smoke-free legislation aside from its impact on
tourism, challenges of developing and implementing smoke-free policies, and consider how to overcome some of the barriers.
Learning Objectives:
To illustrate how tourist destinations become smoke-free and to identify important factors in that process, aiming to provide lessons learnt for policy-makers,
tobacco control advocates, and all others wishing to implement or extend their local policies for smoke-free environments.
Target Audience: All

S5-06

Tobacco Control in Hong Kong: a 30-year Experience

Lisa LAU, Vienna LAI
Hong Kong Council on Smoking and Health
Introduction and Background: Thirty years ago, smoking was prevalent in all indoor and outdoor areas in Hong Kong. The public was bombarded withtobacco products, tobacco advertisements and promotion as well as secondhand smoke. At that time, one in every four or five adults was a smoker.
After enactment of Smoking (Public Health) Ordinance in 1982 and subsequent amendments, the Hong Kong Government has progressively tightened its
control on smoking. The multi-pronged comprehensive tobacco control strategies, including increment of tobacco tax, expansion of statutory no smoking areas,banning of tobacco promotion, introduction of effective health warning at cigarette packs and health promotion programmes, quality smoking cessation services,surveillance and monitoring on smoking patterns in Hong Kong, have proven successful.
The purpose of this paper is to review the effectiveness of these multi-pronged strategies of Hong Kong in the past 30 years with MPOWER, six effective tobacco
control policy package and to look into the future directions in filling the loopholes of current smoke-free legislation. Monitor tobacco use and prevention policies:
Through regular surveys of Census and Statistics Department of Hong Kong Government and research studies of academia and COSH, the smoking prevalencein Hong Kong could be closely monitored with a continuous decline since 1980s. Protect people from tobacco smoke: In order to protect people from the hazardsof secondhand, the Hong Kong Government has been progressively expanding the no smoking areas. After years of advocacy actions from public health experts,
tobacco control alliance and supports from the general public, the total smoking ban could be fully implemented in phrases from 2007 onwards. Warn about
the dangers of tobacco: From simple health warning label to pictorial health warning labels, Hong Kong took more than twenty years to internalize the hazardsof smoking on every citizens. Enforce bans on tobacco advertising, promotion and sponsorship: Tobacco promotion, advertisements and sponsorship had been
progressively restricting and now are fully banned in Hong Kong after years of advocacy. However, tobacco industry still make use of brand extension andvarious indirect marketing tactics to promote their products. Raise taxes on tobacco.: The challenges of raising tobacco tax in past 30 years, especially the raiseof tobacco tax in 2009 and 2011 were reviewed and had illustrated that raising tobacco tax has always been an effective way in reducing tobacco consumption
and deter youth smoking. Offer help to quit tobacco use: The Hong Kong Government has been taking a leading role in expanding quality and community-basedsmoking cessation services for the general public with the support of medical and health institutions, academia and charitable organizations. Conclusion: With
tremendous determination and efforts of the Hong Kong Government and public health advocators in past 30 years, the smoking prevalence of Hong Kong has
dropped from 23.3% in 1982 to the historical low level, 11.1% in 2010. However, in view of the loopholes of current smoke-free legislations, there is a long way
in supporting 700,000 current smokers to quit and protecting 7 million passive smokers before a smoke-free Hong Kong could be constructed in 2022.

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S6-01

Tobacco Cessation Interventions for Tuberculosis Patients

Tara S BAM1, Md Akramul ISLAM2, RUBAEAH3, Rana J SINGH4, Lin YAN5International Union Against Tuberculosis and Lung Disease1, BRAC Health, Nutrition & Population Program2, Bogor City Health Office3, The Union SouthEast Asia Office4, The Union China Office5
Introduction: The Union Lung Health Scientific Section established a working group in December 2009 to research a simple, cost-effective approach to smoking
cessation for TB patients. This group’s efforts led to the development of the ABC approach outlined in The Union guide Smoking Cessation and Smokefree
Environments for Tuberculosis Patients published in 2010. The ABC (A=ask, B=brief advice, C=cessation support) approach was piloted in Bangladesh, China,
India and Indonesia.
Objectives: To share the outcomes and lessons learnt from implementing The Union’s Guide Smoking cessation and smokefree environments for tuberculosis
patients
Methods: Key approaches are; establish TB services 100% tobacco-free, presents ‘ABC for identifying TB patients who smoke, helping them quit, and promoting
smokefree homes for patients and families. It is delivered systematically within routine programme and can be done within 5-7 minutes.
Results: In Bangladesh, BRAC piloted the ABC approach in 17 peri-urban DOTS centres from May 2011. Cohort results (May-August) for the 239 new sputumsmear positive TB patients showed that 80% of them successfully had quit smoking by the end of their six-month TB treatment.
In Indonesia, 10 primary health care centres offered ABC smoking cessation starting from March 2011 in Bogor city. Between March and August, 211 new TB
patients were diagnosed, of whom 165 (72%) were current smokers. Of the 165 patients, 60.6% had quit smoking at the end of 6 months, and 65% had madetheir homes smokefree.
In India, patient enrolment was started in October – December 2010 in 2 districts Kamrup (Assam) and Vadodara (Gujarat). A total of 2879 TB patients wereregistered. Of them, 46.3% (1333) were any form of tobacco users and they were enrolled in the cessation intervention. At the end of 6 months, 67.5% remained
quitters.
In China, patient enrolment started from March 1 to August 31st in 2010 in 2 districts Ningdu and Xingguo. Among 801 TB patients registered, 245 were current
smokers. Of the 245 current smokers, 68.5% quit smoking successfully at the end of 12 months.
Conclusion: The results were self-reporting but it indicates that smoking cessation intervention is feasible and doable at the DOTS clinic.
Key Words: Smoking, Cessation, Tuberculosis

S6-02

Smoking and Tuberculosis

Chi Chiu LEUNG
Tuberculosis and Chest Service
The association between smoking and tuberculosis (TB) was investigated as early as 1918. However, the impact of tobacco smoke on TB was not fullyrecognized until the last decade. In a prospective community cohort of 42,655 elderly subjects in Hong Kong, the annual TB notification rates were 735, 427,
and 174 per 100,000 among current smokers, ex-smokers and never-smokers respectively. A statistically significant and independent dose-response relationshipwas also observed among current smokers. Smoking accounted for 32.8% and 8.6% of the TB risk among males and females respectively, as well as 45% of thegender-related difference. Smoking cessation could potentially half the risk.
Smoking also increases the risk of TB infection and mortality, albeit with more heterogeneous effect sizes. More aggressive lung involvement, with cough,dyspnoea, upper zone involvement, cavity, miliary lung involvement and positive sputum culture, has been observed in smoking–related TB. Non-adherence /default and relapse are also commoner among smokers. Many of these features would point to increased infectious risk, emergence of drug resistance and / orpoorer prognosis.
In another prospective cohort involving 15,486 elderly Chinese female never-smokers, passive exposure to second-hand tobacco smoke was independently
associated with the development of both active TB (HR, 1.49) and culture-confirmed TB (HR, 1.70). Overall, passive smoking accounted for as much as 13.7%of active TB and for 18.5% of culture-positive TB within that cohort.
With the high prevalence of tobacco smoking in the Asia-pacific region, especially among the males, tobacco control will decrease the number of infectious
sources and protect vulnerable contacts, even in presence of multiple and / or extensive drug resistance. In a time-based, multiple risk factor modelling study,
complete cessation of smoking and solid-fuel use in China would reduce the projected annual tuberculosis incidence in 2033 by 14–52% even in presence of 80%
DOTS coverage. It is therefore time for ACTION, rather than lip service!

S6-03

Smoking Habit of Tuberculosis Patients in Japan

Toru MORI, Yuko YAMAUCHI
Research Institute of Tuberculosis
Objectives: To observe the smoking habits of tuberculosis (TB) patients in Japan and how they change in the course of treatment.
Study Subjects & Methods: A total of 1,366 TB patients were enrolled in the study. They were registered as TB patients in 28 public health centers in 11
prefectures in Japan, during 2010 and 2011. The patients were interviewed by public health nurses of each health center soon after registration, and their smoking
habits were recorded. Patients were again questioned about their smoking habits upon completion of treatment.
Results: At the time of TB diagnosis, 33% of the male patients and 9% of the female patients smoked more than a cigarette a day. The prevalence of smoking of
the general population to the TB patients was 26% for males and 6% for females after age adjustment, which clearly indicates that more TB patients smoke than
do members of the general population. The prevalence of smoking was higher in unemployed patients on welfare assistance. It was also found that the patientswith more risk factors as defined in the TB patient’s treatment risk evaluation inventory had higher smoking prevalence.
Upon completion of treatment, 37% of the patients who were smoking initially quit, and 14% reduced their cigarette consumption, while 50% still continued tosmoke as before. Female patients are slightly more likely to quit than males (41% vs. 36%). Aged patients had the highest percentage of people who quit smoking,followed by the younger patients; middle-aged patients had the lowest quitting percentage. Smokers who consumed more than 25 cigarettes a day had the lowest
quitting rate, followed by medium smokers, and then light smokers. Based on the patient category, the quitting rate is highest for new smear-positive patients,
probably due to hospital isolation for at least several weeks.
Discussion: Japanese TB patients’ high smoking prevalence has dual meanings, first as a risk factor predisposing them to TB and second as a risk behaviorsocioeconomically linked to TB. Quite noticeably, a large part of the TB patients still do not quit smoking despite the painful experience of becoming a victim
of smoking and the heavy economic and psychological costs due to TB treatment, including long-term hospitalization. This demonstrates that the educationand support given to TB patients by clinical services and public health providers are not sufficiently effective and that there is ample room to enhance specificactivities targeting smoking and TB.

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Helping TB Patients Quit Smoking: The Potential Impact, WHO Recommendations and Country Experience

Dongbo FU
World Health Organization
The confirmed causal associations between tobacco use and TB outcomes form the basis for joint efforts to tackle the dual epidemics. Therefore, the National
TB programme (NTP) and the National Tobacco Control Programme should strengthen their collaboration to achieve mutual benefits. In collaboration with
the International Union Against Tuberculosis and Lung Diseases (The Union) and the WHO Stop TB! Department (STB), WHO’s TFI developed policy
recommendations and identified intervention models on how to integrate TB and tobacco control measures in primary health care settings as part of the WHO/The Union Monograph on TB and Tobacco Control.
TB care providers are typically in regular contact with TB patients under the directly observed therapy, short-course (DOTS) for a minimum of six months. This
represents a unique opportunity to deliver smoking cessation interventions. WHO recommends that TB patients who are smokers should be specifically identified
and offered advice and other assistance on quitting. The author will first provide an introduction to the WHO recommendations on integrating TB and tobacco
control measures in primary health care, the potential impact of brief tobacco interventions in TB programs on service delivery and saving lives in Asia-Pacificcountries, and an overview of WHO technical resources and tools for promoting integration of TB and tobacco control in primary health care. The author willthen present some country experiences, the existing challenges and lessons learnt in integration of brief tobacco interventions into TB treatment program and the
proposed next steps in advancing this TB and tobacco joint work at country level.

S6-05

The Association between Smoking and Sputum Smear-positive Pulmonary Tuberculosis in Osaka City

Jun KOMUKAI1, Kenji MATSUMOTO1, Shinichi KODA1, Kazuhiko TERAKAWA2, Akira SHIMOUCHI3
Osaka City Public Health Office1, Osaka City Health Bureau2, Osaka City Nishinari Ward3[Purpose] This study aimed to analyze and evaluate the association between tuberculosis (TB) and smoking in order to obtain basic information for the controlof smoking.
[Methods] Of the 637 patients with sputum smear-positive pulmonary TB who were newly registered in Osaka City in 2009, 581 patients whose smoking status
was identified were selected as study subjects. Data on the following were collected: patient characteristics, presence or absence of underlying conditions,patient’s delay and doctor’s delay in the diagnosis of TB, presence or absence of cavities, and degree of smear positivity. The patients were divided into thefollowing three groups according to their smoking status: (1) never smokers (those who have never smoked), (2) former smokers (those who had smoked, but
quitted), and (3) current smokers (those who smoke currently).
[Results] (1) Patient characteristics: The subjects consisted of 413 males and 168 females, with mean ages of 65.7, 55.4, and 70.2 years for never smokers,
current smokers, and former smokers, respectively. (2) Comparison with the national adult smoking rate (National health and nutrition survey 2009, Ministryof Health, Labour, and Welfare): The prevalence of current smoking patients among male patients with sputum smear-positive pulmonary TB in Osaka was
62.4-82.4% among men in their 20s to 60s, and 27.5% among men in their 70s, which is higher than the national average. For female patients, the prevalenceof current smoking was 46.2% among women in their 20s and 45.5% among women in their 30s, which is clearly higher than the national average. This was
also true for those aged 40 years or older. (3) Severity of TB disease and smoking status: The presence of a cavity was significantly associated with being a malepatient, being a current smoker, and longer patient’s delay. Sputum smear grades (2+) and (3+) were significantly correlated with being under 59 years old, being
a current smoker, and longer patient’s delay.
[Conclusion] The prevalence of current smokers was higher among sputum smear-positive pulmonary TB patients in Osaka than the national average. Moresmokers had cavitary lesions and a high degree of smear positivity, which may lead to poorer treatment outcomes, and may also expose more surrounding people
to infection.

S7-01

Women and Tobacco Use in ASEAN: Challenges and Way Out

Bungon RITTHIPHAKDEESEATCA
While Asia’s nearly 3.8 billion people accounting for over 60% of the world population, including over 1 billion each from China and India, the 10 ASEAN
countries are home to almost 599 million people or about 9% of the world population. Country estimates show that almost 30% or about 127 million of the adult
ASEAN population are current smokers, accounting for 10% of the world’s 1.25 billion adult smokers.
Though prevalence of tobacco use among women in ASEAN is very low, there is an alarming situation where the prevalence is likely to increase significantlyin the near future. The Global Youth Tobacco survey conducted in many ASEAN countries showed that more than 5% of girls in some countries have initiatedsmoking.
Thus girls in the region are potential target of tobacco industry. The tobacco industry has already started their aggressive marketing plan targeting girls in theregion many years ago. Launching new products, new pack design, new brands are among those strategies aiming to lure more girls to start smoking.
To prevent youth both boys and girls from starting smoking, many government have actively implemented WHO FCTC. Tax and price measure is used in Brunei
Darussalam, Malaysia, Singapore and Thailand but this policy has been countered by tobacco industry by launching cheap price brand. Tobacco advertising,promotion and sponsorship is banned in most countries except Indonesia, however using social media to promote tobacco products is widely seen in the region
as well as cigarette pack display at point of sale. While many countries have limited budget for tobacco control program, heath warnings on tobacco products
have not yet been effectively used by 6 out of 10 countries to educate the public on the harms of tobacco use.
ASEAN countries should consider banning flavored cigarette and requiring plain packaging of tobacco products since tobacco industry use products andpack design to target young women in the region. It is evident that ASEAN countries need to strengthen their tobacco control measures to prevent their young
population particularly girls from taking up tobacco use, otherwise the smoking prevalence in women will rise rapidly in the near future.

89

S7-02Prevention and Management of Tobacco Use and Exposure to Second-hand Smoke in Pregnancy. A New WHO
Publication

Carmen Audera LOPEZWorld Health Organization
The global tobacco smoking epidemic is shifting from high-income countries to low- and middle-income countries (LMICs), where the prevalence of tobaccosmoking among women is increasing. The rise in tobacco use among younger females in high-population countries is one of the most ominous potential
developments of the epidemic’s growth. While globally manufactured cigarettes remain the most commonly used form of smoking tobacco, the use of otherforms of smoked tobacco is increasing among young women around the world. Also, many forms of smokeless tobacco are heavily consumed by women in many
countries across all WHO regions.
Tobacco consumption whether smoked or smokeless forms as well as exposure to second-hand smoke (SHS) have been shown to cause adverse outcomes inpregnant women and their fetuses and newborn infants. In the Western Pacific Region it is estimated that 50% of the women are exposed to SHS mainly in theirhomes. There is also evidence that in some countries in the Region women consume other types of tobacco during pregnancy such as smokeless tobacco or handrolled cigarettes.
Up to date there were no suitable, evidence-based guidelines for identifying and managing tobacco use and exposure to SHS in pregnancy in LMICs.
Recognizing this need, the World Health Organization in collaboration with the Division of Reproductive Health and the Office on Smoking and Health, Centers
for Disease Control and Prevention, USA and Tobacco Control Research Branch, National Cancer Institute, USA has developed WHO recommendations for theprevention and management of tobacco use and second-hand smoke exposure in pregnancy. These recommendations are targeted to health care professionals
involved in the care and treatment of pregnant women in health care facility and community settings as well as to public health policy makers, health careprogramme managers, and health facility managers.
The objective of this document is to reduce tobacco use and SHS exposure in pregnant women by providing evidence-based recommendations to health careproviders and other related service providers on identification, management, and prevention of tobacco use and SHS exposure in pregnant women and, where
relevant, on tobacco use cessation and advice on how to reduce SHS exposure of pregnant women to other members of their household.

S7-03

Assessing the Feasibility of Plain Packaging of Tobacco Products as a Tobacco Control Measure in India

Monika ARORA1,2, Abha TEWARI2, Nathan GRILLS3, Juhi SONREXA3, Gaurang P. NAZAR2, Rob MOODIE3, K Srinath REDDY1
Public Health Foundation of India1, Health Related Information Dissemination Amongst Youth2, Nossal University of Melbourne3
Background: Tobacco packages are valued by the industry as a product promotion strategy among current and potential users, alike. Evidence from developed
countries suggests that plain packaging may stand out as an important tobacco control measure. A Taskforce consisting of experts in tobacco control from theNossal Institute for Global Health, University of Melbourne, Public Health Foundation of India and Health Related Information Dissemination Amongst Youth,
collaborated to conduct a study that assessed perceptions and support among the Indian populace about plain packaging for all tobacco products as a componentof a larger initiative that aimed to determine the viability of plain tobacco packaging as tobacco control measure in India.
Methods: This cross-sectional study included 12 focus group discussions (n=124), stakeholder analysis with 24 Government and non-government officials andan opinion poll with 346 Delhi-based participants conducted between December 2011 to May 2012. Qualitative thematic analysis was conducted using NVIVO
9. Chi-square tests were applied to test differences in perceptions about plain packaging among different socio-demographic groups using SPSS 17.0.
Results: Using expensive tobacco brands reflected an aspirational value. Overall, the impression was that plain packaging would heavily reduce the appeal of
tobacco packs especially among the children and adolescents. It was perceived that plain packaging would make a difference as taking out a cigarette from anattractive packet was associated with a style statement for the youngsters.
Across all demographic groups currently existing tobacco packs were considered to be attractive (76%). Misleading imagery on tobacco packs was widely
noticed and perceived to distract from the health warnings (83%). Plain packages for tobacco products were favoured by majority of participants (69%) and key
stakeholders (92%). The majority of participants perceived that plain packaging would reduce the appeal and promotional value of the tobacco pack (>80%),
prevent initiation of tobacco use among children and youth (>60%), motivate tobacco users to quit (>80%) and increase noticeability and effectiveness of
pictorial health warnings on tobacco packs (>90%). The majority of participants favoured light grey colour for plain packaging.
Conclusion: This study provides key evidence to assist the Indian Government and other countries in the South Asia region in favour of plain packaging as a
viable tobacco control measure.

S7-04

Women’s Network for Smoke-Free Thai Communities

Chanthana VITAVASIRI, S. AROONPRAPAN, R. TORPRADIT, B. PISANSARAKIT, A. TARADOLRATANAKORN, Somsri PAUSAWASDI
Thai Health Professional Alliance Against Tobacco
Background: In 2011, while 41.7% of Thai men smoked, only 2.1% of Thai women did. In Thai families, women ensure that their family members andenvironment are safe. THPAAT, therefore, sees that Thai women’s skill development and network establishment would help establish and sustain smoke-freecommunities in Thailand. Health personnel would support academic information for such communities. Objective: To identify a model that Thai women’s
network could adopt to establish and sustain smoke-free communities. Materials and Methods: THPAAT appointed a committee, set criteria for community
selection, set evaluation criteria for smoke-free Thai communities, selected communities, educated communities about harms of smoking, educated communities’
members about tobacco control national plan, national laws, and SWOT analysis. Selected communities would appoint personnel to implement smoke-freecommunities for one year (March 2012 to February 2013), evaluate the progress, identify a road map for smoke-free communities, identify methods for cessation
services and plans to decrease smoking in the communities. The project aims to establish a model of Thai women’s network that each community could adopt inorder to establish and sustain a smoke-free community. Results: THPAAT committee chose four rural and two urban communities. The four rural communities
are Ban-Rong (northern Thailand), Ton-Han (central Thailand), Nern-Rae (eastern Thailand), and Klong-Li (northeastern Thailand). Ban-Rong, Ton-Han, NernRae, and Klong-Li have 146, 144, 147, and 100 households. The smoke-free percentages of total households are 61%, 70.8%, 59.2%, and 44%; and thepercentages of population of 15 years old or older who smokes are 16.2%, 9.1%, 20.2%, and 18.8%, respectively. The two urban communities are Krabi-Ta-Rua(southern Thailand) and Salaloi (northeastern Thailand), which have 725 and 507 households, respectively. In Krabi-Ta-Rua, the smoke-free percentage of total
households and the percentage of population of 15 years old or older who smokes are 87% and 4.5%, respectively. All six committees participated in primary
survey and SWOT analysis, and set up plans to decrease the number of smokers, to prevent new smokers, and to establish a surveillance system for smoke-freepublic place. After 9 months from the start of the project (December 2012), the four rural communities has set up various cessation services, such as traditional
medicine or foot reflexology, along with counseling and motivation sessions. In the four rural communities, the percentage of smoke-free households increased
by around 6-8%, and 15-23% of initial smokers were able to quit smoking. In the two urban communities of Krabi-Ta-Rua and Salaloi, 89% and 62.5% ofsmokers attended the cessation services, while 24% and 33.3% of initial smokers were able to quit smoking for more than 6 months, respectively. Salaloi hasconcentrated in preventing new smokers in three primary and secondary schools. The final results of the project and model of smoke free communities will beconcluded in March 2013 and will be presented later. Lessons Learned: Key success factors of women’s network for smoke-free Thai communities are: clear
understanding of structure and context of the communities, suitable working groups, and rewards or positive reinforcement. Public health volunteers play animportant role in implementing this project. Rural communities show that they have potential to build smoke-free communities continuously and sustainably.
However, they need further follow up and education support. Keywords: Women’s network, smoke-free Thai communities, cessation, public health volunteer.

90

S7-05

Awareness of Smoking and Second-hand Smoke among Japanese women

Reiko SAITO
Jumonji University
Introduction
The percentage of smokers in Japan has recently decreased, though the difference in terms of percentage between men and women in Asia is rather striking. The
percentage of female smokers in Japan has not diminished. Regardless of gender, the percentage of smokers is high among the younger generations, but themain issue is that they are of the childbearing and childrearing generations. With the diminution of smokers, tobacco companies are launching catchy products
whose targets are women, such as flavored cigarettes, cigarettes that barely produce smoke, and cute and colorful packages with gimmicks. Furthermore, womencan easily buy cigarettes at convenience stores and vending machines. At work, many companies have smoking areas, so break times increase. According toa national survey by the environment agency, 10% of young pregnant women under the age of 24 are smokers. The national regulation to protect non-smokers
from second-hand smoke is not adequate and women and children are frequently exposed to such situations.
Research
We conducted a survey among female college students during their first year (aged between 18 and 19) about their opinions about the prevention of second-handsmoke. We conducted the survey prior to a seminar on the effects of smoking.
Results(1) Regarding smoking areas in restaurants, many answered “I choose the non-smoking area because I do not smoke”, adding though, “I sit in the smoking area
if I am with someone that smokes”. (2) If asked by someone sitting nearby whether they could smoke, the majority answered “I hate it, but I`d say that I don’tmind”. Other answers were “Fine by me”, “I will say ok and leave my seat” and “I hate it”, which was the least common answer.
Conclusion
The situation shows us a lack of knowledge regarding the effects of second-hand smoke and that there are many girls who cannot speak their minds. In Japan,
because non-smokers of both sexes normally sit in smoking areas to accompany people that smoke, the result is that many of them suffer the consequences forsuch situations. If smoking in restaurants was prohibited completely, this problem could be resolved. The students involved in the survey said that they soughta non-smoking partner though they would have to state, “I hate tobacco”. They should also demand non-smoking as a condition for marriage.

S7-06

Changes in Gender Differences on Smoking Behavior and Perception in Thailand: A Longitudinal Descriptive Analysis
from ITC-Thailand Waves 1 - 5

Aree JAMPAKLAY1, Buppha SIRIRASSAMEE1, Charamporn HOLUMYONG1, Ron BORLAND2, Geoffrey T. FONG3
Mahidol University1, The Cancer Council Victoria2, University of Waterloo3
As the tobacco industry taps into gender differences to exploit an important market segment of women, understanding gender differences in tobacco use isimportant. While rates of smoking among men are about 4 times higher than women (48% VS 12% globally) and smoking rates have either reached a plateau or
are in a slow decline among men, the prevalence of tobacco use among women is on a rise. It is predicted that by 2025, 20% of female population will be smokers.
Moreover, the gender health consequences illustrate that women are at greater disadvantaged compared to men. The increase in female smoking, especially indeveloping countries, can be explained by several factors. But previous research suggests that the most important factor may be the rise in women’s autonomy
and changes in women’s role which makes cigarettes more affordable and smoking more acceptable.
This paper aims to explore smoking behavior and perceptions towards smoking among Thai female smokers and how they have changed over time compared tomales. The paper will also explore gender differences in their exposure to tobacco advertising and promotion as well as to tobacco control campaigns over time.
We will employ data of adult smokers interviewed in the ITC-Thailand project surveyed annually in 5 waves, 2005 to 2010. Of the sample in the 1st wave, 8.6%
or 172 among 2,000 adult smokers are women. Descriptive analysis showing smoking behavior of female smokers, their perception towards smoking, as wellas their exposure to tobacco advertising and tobacco control campaigns compared to males will be conducted. Further analysis on changes over time between
women and men will also be presented.
Knowledge on gender differences in tobacco use is instrumental for tobacco control targeting to protect women from smoking. In the Thai context, the proportionof women smoking is relatively low compared to western countries. Knowledge on gender differences in the context where smoking in women remains relatively
less prevalent will result in a tremendous benefit in formulating preventive policy and program to save women from using tobacco.

S8-01

Roles of Nurses and Healthcare Professionals in the Tobacco Epidemic

Sophia CHAN
Under Secretary for Food and Health, The Hong Kong Special Administrative Region Government
Tobacco kills. Smoking is harmful to the individual smoker and the community at large. In Hong Kong, tobacco is responsible for over 6 900 deaths a year.
The Hong Kong SAR Government has taken a progressive and multi-pronged approach in the prevention and control of tobacco use. We first introduced ourlegal framework to control tobacco sale and smoking in 1982, and have since stepped up our tobacco control on all fronts progressively. Smoking is now
prohibited in all indoor workplaces and public places as well as many outdoor leisure grounds. All forms of tobacco advertisements are now banned. Tobacco
duty has also been raised many times and it now accounts for about 69% of cigarette price. We have been increasing resources and partnering with community
organizations in providing smoking cessation services.
Through legislation, publicity, education, enforcement, smoking cessation and taxation, we aim to contain the proliferation of tobacco use and minimize theadverse effect of second-hand smoke. Thanks to our healthcare professionals, non-government organizations, researchers and relevant stakeholders, the smoking
prevalence in our population has dropped significantly from 23% in the 1980s to 11% now - one of the lowest in Asia.
Healthcare professionals such as nurses play a significant role in combating the tobacco epidemic through prevention, public education, cessation services,advocacy and research. For example, nurses operate the Government’s integrated smoking cessation hotline to provide education, counseling and referral
services to smoking cessation clinics. The University of Hong Kong trained nursing students to act as peer counselors under a Youth Quitline to help youngsters
aged 13 to 25 years quit smoking. Recently, the Provisional Hong Kong Academy of Nursing and the Hong Kong Council on Smoking and Health signed thefirst Nursing Charter on Tobacco Control, further signifying the commitment of our nurses in tobacco control.
We place great emphasis on training. We provide evidence-based smoking cessation training for our healthcare personnel and equip them with counseling skills
and knowledge of pharmacotherapy. Other than the training provided locally by universities, the World Health Organization Collaborating Centre on Smoking
Cessation and Treatment of Tobacco Dependence, the first of its kind established in Hong Kong in 2012, provides training to healthcare professionals; develops,
tests and evaluates models of smoking cessation; and supports WHO's initiatives on smoking cessation. Since its establishment, over 100 healthcare personnel
have been trained in smoking cessation services.
Notwithstanding the considerable progress made, we cannot afford complacency. Our healthcare professionals, nurses, non-government organizations,researchers, and the community at large will keep up the efforts on fighting against this global health epidemic.

91

S8-02

Roles of Nurses and Other Health Professionals in the Tobacco Epidemic: Experience of Indonesia

Soewarta KOSEN
National Institute of Health Research & Development
The 2011 Indonesian Global Adult Tobacco Survey (GATS) found that 36.1 % of the population (67.4 % males and 4.5 % females) aged equal to or more than
15 years are active smokers. Current tobacco use (kretek or clove cigarette) was more prevalent in rural areas (39.1%) compared to urban areas (33.0%). The
average number of cigarettes smoked per day was about 13 sticks (13 sticks for males and 8 sticks for females). Among adults aged 20-34 years, the average
age at initiation of daily smoking was between 17 to 18 years. The health professionals (medical doctors, dentists, nurses, midwives, pharmacists, sanitarians,
psychologists, etc.), that are widely distributed in public and private health facilities, may reach a high percentage of the population and have the opportunity
to assist people change their unhealthy behaviour. They can provide advice, guidance and answers to questions related to the negative consequences of tobaccouse, help patients to quit smoking and forewarn children and adolescents of the dangers of tobacco use. Besides, the health professionals may routinely inquirepatients about tobacco consumption and exposure to tobacco smoke, participate in the tobacco-control activities of comunity or civil society, encourage policymakers to take action as well as conduct campaigns for tobacco-free public places. At present, major health professional associations, namely Indonesian
Medical Association, Indonesian Nurses Association and Indonesian Midwive Association are also active members of the National Commission on Smoking
Control who leads the tobacco control activities in the country. Health researchers at The National Institute of Health Research and Development also monitor
tobacco use and prevention policies periodically, collect evidence to support efforts in tobacco control and formulate laws and regulations to curb tobacco
epidemic. Besides, a community based smoking cessation counselling are also being tried out in several urban and rural area of Indonesia with successful
preliminary results. Hopefully, concerted tobacco control efforts by health professionals may contribute significantly to the improvement of community healthstatus and a more systematic approach to build capacity and engage health professionals in tobacco control efforts should be continuously implemented.
KEY WORDS: health professionals, roles, tobacco epidemic, Indonesia

S8-03

Smoking Status and the Kano Test for Social Nicotine Dependence (KTSND) in Employees of a Regional Cancer Centerin JapanKenji AMAGAI
Ibaraki Prefectural Central HospitalObjectives. We investigated the prevalence of smoking and attitudes concerning smoking among employees of a cancer hospital using the Kano Test for Social
Nicotine Dependence (KTSND).
Methods. A self-administered questionnaire, including the KTSND as well as questions regarding smoking status, occupation and demographics were collectedfrom 611 employees of a regional cancer center in 2008. Same questionnaire were collected from 853 employees in 2010.
Results. The smoking rates were as follows in the first investigation in 2008: medical doctors, 5.4% (male 5.8%, female 0.0%); nurses, 17.4% (male 50.0%,
female 15.5%); other medical workers, 3.9% (male 7.7%, female 0.0%); clerical or site maintenance workers 21.9% (male 39.7%, female 12.4%). The KTSND
scores (mean ± standard deviation) of 14.7 ± 4.4 for smokers were significantly higher than those of 12.2 ± 4.7 for past smokers, and 11.0 ± 5.9 for neversmokers. Although the KTSND scores were not different in each occupational category among never smokers, those for clerical or site workers (17.2 ± 5.4) weresignificantly higher than those for medical doctors (12.3 ± 6.2) or nurses (13.7 ± 5.0) among past or current smokers. Current smokers but also never and pastsmokers gave a strongly positive response to permission of smoking where ashtrays are available. The smoking rates were as follows in the 2nd investigationin 2010: medical doctors, 9.4% (male 11.0%, female 0.0%); nurses, 13.4% (male 44.4%, female 11.9%); other medical workers, 6.0% (male 13.0%, female
0.0%); clerical or site maintenance workers 17.2% (male 31.5%, female 12.3%). The KTSND scores (mean ± standard deviation) of 16.7 ± 5.4 for smokers weresignificantly higher than those of 13.4 ± 5.8 for past smokers, and 11.3 ± 5.6 for never-smokers.
Conclusions. The prevalence of smoking in the staff in a regional cancer center was not lower than expected. A significant difference was observed in KTSND
scores according to smoking status, and the KTSND scores differed according to occupational category in the hospital. The prevalence of smoking and theconsciousness about smoking in the staff did not change so much in two years. It is suggested that it is necessary to remove ashtrays and abolish smoking areas
to discourage smoking in hospitals.

S8-04

Epidemiological Study of Smoking among Japanese Physicians

Maki IKEDA , Yoshitaka KANEITA2, Osamu ITANI1, Satoshi IMAMURA3, Takashi OHIDA1
Nihon University1, Oita University2, Japan Medical Association3
1

Objective: We attempted to clarify recent changes in the prevalence of smoking among Japanese physicians, and to verify their attitude to the patient's smoking.
Method: This study was carried out by Japan Medical Association and Division of Public Health, Nihon University School of Medicine jointly. We conductedfour self-administered questionnaire surveys on the members of the Japan Medical Association in 2000, 2004 and 2008, and 2012. In the survey in 2000, 2004
and 2008, 3000 male and 1500 female physicians were randomly selected. Six thousands male and 1500 female physicians were randomly selected in thesurvey in 2012. The questionnaires included personal characteristics, current smoker, supervised antismoking and lifestyle habits. The trend of the prevalence ofsmoking among physicians, and their attitude to patient's smoking were compared among 4 surveys.
Results: The total number of effective responses was 3771 in 2000, 3633 in 2004, and 3486 in 2008, 5854 in 2012. The prevalence of smoking among male
physicians was 27.1% in 2000, 21.5% in 2004, 15.0% in 2008 and 12.5% in 2012. The prevalence of smoking among female physicians was 6.8%, 5.4%, 4.6%
and 2.9%, in 2000, 2004, 2008, and 2012, respectively. The ratio of the physicians who answered "Patients should not smoke" was 42.8% in 2000, 49.4% in 2004,
52.4% in 2008 and 54.5% in 2012 survey, respectively in the male (p<0.01), and it was 42.6%, 52.2%, 59.3%, 62.0%, respectively in female physicians (p<0.01).
And the ratio of the male physicians who answered "I’m willing to introduce specialist to patients" increased significantly.
Conclusions: The prevalence of smoking among Japanese physicians has shown a declining trend. Depending on those results, we can expect that anti-smoking
campaign will achieve a certain result in future.

92

S8-05Developing a Teaching Module on Tobacco Control for Health Professionals in Malaysia

Amer Siddiq AMER NORDIN1,2, Farizah MOHD HAIRI1, Christopher BULLEN3, Rahimah A. KADIR1,4
University Malaya1, University of Otago2, The University of Auckland3, Lincoln University College4
Introduction: The Malaysia Global Adult Survey (GATS) reported 23.1% of Malaysians were current smokers and majority were men. The GATS also foundthat just half of the respondents reported being advised to quit during their health visits and only 14% reported thinking of quitting within the year. A conferenceon smoking cessation conducted by in early 2012 noted that of the 186 local participants (medical, dental and other health care providers) in attendance, a highnumber agreed having limited understanding on tobacco control and reported not confident in providing treatment. A subsequent survey in late 2012 amongst
junior medical doctors found similar concerns on knowledge and confidence in treating smokers. These findings supported the earlier GATS report which foundjunior doctors “advising patients to quit only half the time”.
In light of these findings on limited knowledge and training, an exploratory study was conducted to identify interest and the possibility of developing a standard
curriculum for health care providers for medical and dental schools, in Malaysia.
Method: A two-day workshop on developing a Tobacco Control curriculum was conducted in November 2012. Senior faculty members from 36 medical schools
and 15 dental schools interested in teaching tobacco control were invited to participate. The workshop content included lectures, small group discussions andbreak-out sessions.
Results: A total of 12 participants from 6 universities comprising of both medical and dental practitioners attended the workshop. There was general agreement
amongst the attendees on the need to set up this initiative. A mock curriculum was developed during the workshop from the break out group discussion.
Discussion and Conclusion: This initiative was a first in Malaysia for gathering both medical and dental educators from local universities to develop a standard
curriculum for teaching on tobacco control. Although attendance was limited, the enthusiasm and ability to develop a mock curriculum indicated both interest
and commitment amongst participants.
Despite these positives, more work is required. The curriculum needs to be improved and field tested. As medical and dental schools are independent in theirteaching material and time, involvement of the Ministry of Higher Education is required to ensure that teaching time and commitment for the setting up of sucha project can be done at the national level. This initiative is important if Malaysia were to meet her obligations as a member of the Framework Convention on
Tobacco Control under Articles 12 and 14 of the framework.

S9-01

Treating Tobacco Dependence

Richard D. HURT
Nicotine Dependence Center Mayo Clinic
Left untreated, tobacco dependence will kill over 60% of current smokers. It is, therefore, imperative that healthcare professionals treat tobacco dependence forthe serious medical problem that it is. The cigarette is the most efficient drug delivery device ever produced. It delivers high arterial concentrations of nicotine
to the central nervous system which causes upregulation of the nicotinic acetylcholine receptors. This upregulation is the primary reason that addicted smokers
have so much difficulty in stopping smoking. There are genetic factors involved because not every person who experiments with cigarettes becomes a smoker,
nor does every smoker become an addicted smoker. Understanding the neurobiology of tobacco dependence is important for the addicted smoker because it
relieves some of the shame and guilt that they have because they have not been able to stop smoking.
For treatment, the evidence shows that motivational counseling and pharmacotherapy are treatments that work, and providing them together increases the
positive treatment outcomes. There is a dose response to motivational counseling in that more frequent, longer, and more intensive counseling produces better
outcomes. The same thing is true for pharmacotherapy. But beyond the dose response, combining long-acting pharmacotherapy with short-acting nicotine
replacement therapy for symptom control is the preferred treatment for most patients.
In recent years, mid-level practitioners who have been specially trained and certified as Tobacco Treatment Specialists are beginning to populate medical centersthroughout the world. These counselors are true experts on treating tobacco dependence and can be of great assistance to physicians and other healthcare
professionals as a resource for treating patients both in the outpatient and hospital settings. More intensive treatment such as residential treatment for patientswith severe dependence is warranted and is highly effective as such patients often require this level of treatment in order to initiate and sustain smoking
abstinence.
Finally, why do we as a civilized society tolerate the carnage produced by cigarettes? It is time for the healthcare professionals to begin the discussion ofending cigarette use and moving toward the “endgame”. Many countries around the world are now considering ending cigarettes as a commercial product andeventually eliminating tobacco use overall. We should not have to tolerate a product that if used as recommended by the manufacturers kills over 5 million
people worldwide every single year.

S9-02

Smoking Cessation Services in Hong Kong: Combing Public Health Approach and Clinical Approach

Christine WONG
Hong Kong Special Administrative Region
Smoking cessation is one of the pillars in curbing the tobacco epidemic. The Tobacco Control Office of Hong Kong has integrated public health and clinicalapproaches in helping smokers to quit.
On public health approach, we create a supportive environment to encourage smokers to quit by expanding statutory smoking ban and introducing pictorial healthwarning on tobacco products. Smoking is now banned in all indoor areas of workplaces, restaurants and public places and some outdoor areas such as parks andbeaches. Designate enforcement teams are established with a view to strengthen the impact of smoking ban and to increase the motivation of smokers to quit.
On clinical approach, different clinical modes of smoking cessation services have been developed to address the diversity needs of the smokers in Hong Kong.
Apart from smoking cessation clinics in hospital setting, we collaborated with community partners to establish community-based smoking cessation centres.
These designated centres are supported by a professional team of doctors, nurses, social workers, clinical psychologist and counselors. They provide counselling
and western medication such as nicotine replacement therapy to help smokers to quit the deadly habit. Over 7200 smokers have received the service since theprogramme started in mid 2009. Evaluations study has shown that 41.9% and 35.9% of service users maintained abstinence at 26 weeks and 52 weeks of followup.
Apart from Western Medicine, we also study the effectiveness of using acupuncture for smoking cessation. In collaboration with a local NGO and expertsof acupuncture, we have developed community-based cessation service in which Chinese Medical Practitioners provide counseling and acupuncture to relieve
withdrawal symptoms of the smokers. To increase accessibility of the service, a total of 18 mobile clinics were operating in over 90 spots in Hong Kong. So far,more than 4200 smokers have received the service and evaluation is underway.
With the designation of the “WHO Collaborating Centre for Smoking Cessation and Treatment of Tobacco Dependence” in Hong Kong since April 2012, wewould continue to adopt both public health and clinical approaches so as to increase the effectiveness and participation of smoking cessation services.

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S9-03

Effectiveness of the Preoperative Smoking Cessation Treatment in Patients with Elective Surgery

Mami IIDA1, Koji ONO1, Hiroki IIDA2, Mayumi KATO2
Gifu Prefectural General Medical Center1, Gifu University Graduate School of Medicine2
Smoking status affects both perioperative risk and outcome. We evaluated the smoking status of surgical patients and the factors relating to preoperative abstinencefrom cigarettes from preoperative interview of 1124 patients who were greater than eighteen years of age, scheduled for elective surgery in 2011 (during 6 months),
and compared with the results of the same interview of 1968 patients in 2006 (during 12 months) in the university hospital. Anesthesiologists interviewed all
patients using a standardized questionnaire that examined the following: medical history, smoking history, and awareness of the risks of perioperative smoking.
Current smoking rate was not different between 2006 (7%) and 2011 (7%). It was more difficult to quit smoking preoperatively for female patients in 2011, andthose with benign disease in both 2006 and 2011. There was no improvement in awareness of the perioperative risk of smoking between 2006 and 2011. As theimportance of perioperative smoking cessation has not been sufficiently well-known for the surgical patients yet, we recognized that medical staff needs to bemade aware of the importance of informing patients that preoperative abstinence from cigarettes may decrease perioperative complications.
Therefore we planned to start the preoperative smoking cessation treatment in patients with elective surgery. When an operation is decided, the explanation is
given to a smoking patient from a doctor about the risks of smoking in perioperative period and the necessity for smoking cessation before an operation. At thesame time, it asks that a patient gives up smoking and gets a consent and signature of a non-smoking declaration. When the patient says that smoking cessation
is difficult by him/herself, we recommend a consultation on the smoking cessation clinic. In smoking cessation clinic, the patient is treated according to the usual
smoking cessation program for 12 weeks in Japan. Although the period to a surgical date may not be enough and it needs to be cautious of drug selection, theintroduction of smoking cessation is comparatively easy, since motivation is high enough and there is a target of a surgery.
In 18 patients who consulted smoking cessation clinic for the purpose of prohibition of smoking by the request from a surgeon in 2012 in our hospital, 100%of patients had attained prohibition of smoking for one week or more at the time of an operation. The preoperative smoking cessation treatment in patients withelective surgery is very effective.

S9-04

Are You ready for Cessation? A Conceptual Framework for Building Cessation Capacity

Annette M. DAVID1, Sophia CHAN2, Susan P. MERCADO3
University of Guam1, The University of Hong Kong2, World Health Organization3
Background: The WHO Framework Convention on Tobacco Control (WHO FCTC) mandates countries to establish effective tobacco dependence treatment.
Currently, over 85% of the world's population has no access to cessation. Majority live in developing countries, many of which are WHO FCTC Parties. As these
Parties enact tobacco control policies, the pressure on tobacco users to quit will increase. Building capacity to meet the anticipated rise in cessation demandrequires a systematic process. A comprehensive approach is necessary, but resource limitations require a realistic approach, especially in low and middle-income
countries (LMICs).
Objective: We pilot tested a systematic assessment process to guide the prioritization of cessation
Figure 1. Cessation pyramid conceptual modelinterventions based on a country’s infrastructure and resources.
Methods: We developed simple planning tools for cessation readiness assessment and capacity mapping,
City Cessation System
based on a theoretical model of cessation capacity as a pyramid with 3 successive levels of interventions.
Individual level
TobaccoTwenty seven participants and faculty mentors from 14 LMICs pilot-tested the assessment process at a
Dependence
Training Workshop on Quitlines in Smoke-free Cities, Seoul, Republic of Korea from 17-20 July 2012. A
Treatment
questionnaire queried participants on: (1) demographic information, (2) ease of use; (3) effectiveness tosystematically assess the cessation situation; (6) adaptability for local use; and (7) usefulness in guiding
Behavioural
Quitline
strategic thinking about cessation capacity building.
Services
Cessation
Results: A total of 25 completed questionnaires were received, for a response rate of 92%. The workbook
Counselling
Promotion
exercises were highly rated for ease of use, effectiveness and adaptability by all participants.
Brief
Community
Brief Advice
TobaccoConclusion: Countries are in different stages of readiness for cessation. As WHO FCTC Parties implement
Community level
stakeholders
Community
Cessation
Smoking
Intervention
tobacco control policies, demand for cessation will increase. This conceptual framework and assessment
PublicPolicyCessation
Resources
Education
process was effective in helping tobacco control programme managers in the Asia-Pacific region tosystematically determine their cessation capacity building priorities.
(3rd level)

HealthMedications
Professionals(2nd Level)(1st Level)

S9-05

Emergency Department-initiated Tobacco Control: Systematic Review and Meta-analysis

Bruce NEUNER1,2, Edith WEISS-GERLACH1, Juergen WELLMANN2, Hans-Werner HENSE2, Gwen L. RABE2, Claudia PIES1
Charité-Universitaetsmedizin Berlin1, University of Muenster2
INTRODUCTION: A 2006 joint statement of US American Emergency Physicians called on emergency care providers to routinely screen emergency department(ED) patients for their smoking status and to support smokers to quit. The effectiveness of emergency department-initiated tobacco control (ETC) is unclear.
OBJECTIVE: Systematic review and meta-analysis of randomized controlled trials (RCTs) examining the efficacy of ETC.
METHODS: Following the PRISMA statement, in October 2010, 6 electronic databases were searched using predefined search terms. Outcome was the numberof abstinent smokers at each follow-up. Relative risks of ETC on point prevalence abstinence were calculated separately for each study and follow-up time and,pooled at different follow-up times, by Mantel-Haenszel relative risks. The effects of ETC on combined point prevalence abstinence across all follow-up times
were calculated using generalized linear mixed models.
RESULTS: The literature search identified 7 relevant studies with a total of 1986 participants out of 4371 records. Three were of moderate and 4 of weak quality
according to the Quality Assessment Tool for Quantitative Studies. Follow-up time varied between 3 and 12 month and the rate of abstinent smokers varied
between 0% and 16%. The strongest effect of ETC on point prevalence abstinence was found at one month: Relative risk (RR) = 1.47 (95% confidence interval(CI): 1.06 to 2.06), 3 studies, while the effect at 3, 6, and 12 months was RR = 1.24 (95% CI: 0.93 to 1.65), 6 studies; 1.13 (95% CI: 0.86 to 1.49), 5 studies;and 1.25 (95% CI: 0.91 to 1.72), 1 study; respectively. The benefit on combined point prevalence abstinence was RR = 1.33 (95% CI: 0.96 to 1.83), p = 0.075, 7
studies; with RR = 1.33 (95% CI: 0.92 to 1.92), p = 0.100, for the 5 studies featuring motivational interviewing combined with booster phone calls.
CONCLUSIONS; The main finding of this systematic review and meta-analysis of RCTs evaluating ETC was a trend towards increased combined point
prevalence abstinence. Sensitivity analyses indicated that this trend was based on ETC in the form of motivational interviewing in combination with booster
phone calls. More methodologically rigorous trials are needed.

94

S9-06

Brief Smoking Cessation Intervention at Health Examination and Training for Health Professional

Masakazu NAKAMURA
Osaka Center for Cancer and Cardiovascular Diseases Prevention
In Japan, health examination is widely conducted at communities and worksites under the law. So it is a good opportunity for motivatingsmokers toward smoking cessation. 64% of smokers participated in health examination or cancer screening. However, only 32% of smokers
received advice to quit from a health professional.
Since 2008, specific health examination and health guidance focused on metabolic syndrome and obesity started to prevent cardiovascular disease and reduce
medical costs. There was a strong criticism from medical societies that it did not lead to prevent cardiovascular disease totally because more than half of the
population is non-metabolic and non-obese. As a result, health guidance to smokers and hypertensive patients on the day of the health examination was reinforced
from April 2013 to prevent cardiovascular disease and other NCDs more effectively.
There is strong evidence that interventions as brief as 3minutues or less can increase cessation rates significantly at clinical setting. At health examination
setting, there is growing evidence that shows the effects of brief intervention. According to our recent study, combination of physician advice and brief cessation
support by public health nurses (1 to 2 minutes) to all smokers increases cessation rates irrespective of readiness for smoking cessation among smokers.
Although proactive quitline is proven to be effective and expected to act as the hub of a network of cessation resources, it is not available in Japan. It isnecessary to establish quitline, especially linked with brief intervention at health examination and other routine healthcare activities
As for the training, the Japan Medical and Dental Association for Tobacco Control has developed e-learning programs (J-STOP) to train health professional,
who can then administer reimbursed smoking cessation treatment as well as proactive brief intervention and cessation supports at routine healthcare activities.
The effects of the training have been examined and started to be disseminated at local prefectural level and national level. The contents of e-learning program
were adopted into smoking cessation manual published by Ministry of Health, Labor and Welfare in 2013, which was developed for reinforcement of smoking
cessation intervention at specific health examination and health guidance.

S10-01

Singapore’s Social Movement in Tobacco Control

Zee Yong KANG
Health Promotion Board
Singapore adopts international best practices in smoking control including legislation, taxation, mass media and face to face smoking control programmes.
Between 1992 and 2010, Singapore’s smoking rate fell from 18.3% to 14.3%, one of the lowest in the world. To further reduce smoking prevalence to below 10%
by 2020, we need all Singaporeans to be part of a national ground-up social movement to champion for a smoke-free Singapore.
To drive this movement, Singapore embarked on a new chapter in tobacco control efforts that seeks to ‘de-normalise’ the smoking habit and promote smoke-freeliving as a social norm. HPB launched a mainstream tobacco control campaign called I Quit in 2011 to encourage smokers to make a personal pledge to quit
by setting up more than 150 convenient and accessible touch points to provide a supportive network across the island. These touch points include a QuitLine,an I Quit Club on Facebook social media, smoking cessation counsellors based at neighbourhood Community Clubs and pharmacies, and smoking cessation
programmes developed in partnership with schools, workplaces and community settings.
A year after the launch of I Quit, more than 30% of smokers who had pledged to quit smoking have done so successfully with the help of HPB, with the numberof smokers seeking help through QuitLine increased threefold, and the number counselled at pharmacies doubled.
Singapore’s unique approach to tobacco control that involves creating a national social movement by mobilising youths, businesses and the community througha network of Health Ambassadors, peer-led Youth Advolution of Health Programme and the Blue Ribbon initiative will be shared at the Conference.

S10-02The Ripple Effect: Using Subnational Campaigns to Model Success for a National Effort in China

Yu CHEN, Yvette CHANG
World Lung Foundation
With a smoker population of over 300 million and 1 million tobacco-related deaths every year, nowhere else is the issue of tobacco and its control more criticalthan in China. Mass media tobacco control campaigns can contribute to increasing knowledge about tobacco-related harms and counter the social acceptabilityof smoking and motivating behaviour change among smokers. Most importantly, mass media campaigns can also play a significant role in building support for
tobacco control policies.
Since ratifying the FCTC in 2005, the tobacco control movement has China has grown, slowly but surely. Due to its highly-decentralized political structure,
momentum at the subnational level has led much of the way, particularly in the area of public education. By the end of 2011, strong public education campaigns
had been mounted in over 20 key cities and provinces across the country. Still, a strong national effort was needed as less than 25% of adults were aware of thehealth harms associated with tobacco use and secondhand smoke exposure.
In 2012, the World Lung Foundation worked with the health promotion arm of China Ministry of Health, the Chinese Center for Health Education, to designand execute China’s inaugural national tobacco control mass media campaign. This presentation will look at some of the subnational campaigns that helped pave
the way, and will also introduce some of the key findings from the national campaign, and explore future strategies.

95S10-03

Trends in Adolescent Smoking Behavior and its Correlates in Japan

Yoneatsu OSAKI1, Takashi OHIDA2, Hideyuki KANDA3, Yoshitaka KANEITA4, Masumi MINOWA5, Susumu HIGUCHI6, Yoko KONDO1
Tottori University1, Nihon University2, Yokohama City University Graduate School of Medicine3, Oita University4, Minowa Epidemiolgy Institute5, National
Hospital Organization Kurihama Medical and Addiction Center6
Nationwide surveys on cigarette smoking among high school students revealed that many students had started smoking in spite of the existence of the Act toProhibit Minors from Smoking, enacted in 1900. We assessed trends in smoking behavior among Japanese adolescents, and analyzed attributable factors to thechanges.
Nationwide cross-sectional surveys were conducted in 1996, 2000, 2004, 2008, 2010 and 2012. Junior and senior high schools were sampled randomly. Enrolled
students were asked to fill up a self-reporting anonymous questionnaire on smoking behavior. Questionnaires were collected from about more than 100 thousands
students in every survey through sampled junior and senior high schools throughout Japan. School principals were asked school policy on smoking restriction.
Cigarette smoking prevalence (lifetime, current, and daily smoking) after 2000 was decreased in both sexes and in all school grades. A decrease in smoking
prevalence in students’ father and senior brother, and an increase in the proportion of students without friends were observed. The proportion of current smokers
who usually bought cigarettes in stores decreased in 2004 especially for senior boys. An association was seen between schools’ lower smoking rate and a smokefree school policy in early 2000s.
After ratification of FCTC (Framework Convention on Tobacco Control) by Japanese government, some progresses in tobacco control in Japan were observed.
The average cigarette retail price was raised from about 300 to 410 JPY/pack in Oct, 2010. However, we could not observed a dramatic decrease in smoking
prevalence, but observed a decreased in average cigarette consumption per day. We still have many problems in tobacco control in Japan, such as insufficient
health warning on package, voluntary regulation of advertisements and sales promotion by the tobacco industry, prevalent of passive smoking among adolescentsin their house. Japanese students learn tobacco and health in their classroom, however, the effectiveness of health education of tobacco and health has not beenstudied.
Japan experienced a decrease in adolescent smoking prevalence. A decrease in smoking prevalence of father and senior brother, reducing minors’ access totobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decrease.

S10-04

Smoking Cessation Interventions in Indonesia

Endah D. PRATIWICenter for community Empowerment, Health policy and Humanities National Institute of Health Research and Development Ministry of Health Republic ofIndonesia
Background: All tobacco products are causing dependence, and can be very difficult to quit smoking or stop using other tobacco products. So it takes aneffective smoking cessation program. Smoking cessation program in Indonesia has not received sufficient attention because of the focus of today's tobacco
control issues prioritized environmental factors that strongly encourage people to quit smoking and prevent smoking
Objective: To evaluate the effectiveness of strategies that help people to stop smoking
Methods: In 2011, a Global Adult Tobacco Survey was conducted in Indonesia. The target population includes all people who consider Indonesia to be theirusual place of residence covering 98,4% of the total population In Indonesia. The Survey used a four-stage stratified cluster sampling design. In the first stage,
50 urban primary sampling units (PSUs) and 50 rural PSUs were selected, from which a total of 8,994 households were selected. A total of 8,581 householdinterviews were completed and one individual was then randomly selected from each participating household. There were a total of 8,305 individual completedinterviews with an overall response rate of 94,3%.
Result: The results of the study shows that a higher proportion of smokers reported quitting on their own/quitting without assistance (70,7%); most of them had
used some methods to quit smoking on their own in the past 12 months. This is followed by another methods (13,6%) including traditional methods (herbal/
medicinal plants), switching to smokeless tobacco and counseling (7,0%). The cessation method that was least used was prescription medication (0,4%).
Conclusion: The study found that 70,7% smokers quitting without assistance. The risk of relapse in smokers who are not assisted much larger compared to thatassisted it. Through public health education regarding the harm of smoking, smokers shall be assisted to quit their habit and their immediate family members
shall be empowered to assist and facilitate the smoking cessation process.
KEY WORDS : Smoking cessation, Intervention, Quitting without assistance

S10-05

Impact of Smoke-Free Melaka City Project on Smoking Attitudes among Adult Smokers in Melaka: Findings from
Evaluation of Smoke Free Melaka Intercept StudyYahya BABA1,Maizurah OMAR2, Rahmat AWANG1,2, Noraryana HASSAN3, Nur Hanani JASNI2, Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH4,
Pete DRIEZEN4, Mary THOMPSON4, Geoffrey T. FONG4My Sihat1, Clearinghouse for Tabacco Control2, Melaka State Health Departments3, University of Waterloo4
BACKGROUND: Melaka took effort into implementing a comprehensive smoke free cities beginning June 2011 with aims to reduce harmful secondhand
smoke exposure to the non-smokers especially women and children living with smokers.
OBJECTIVES: To evaluate the impact of the project towards smoking attitudes within one year of implementation.
METHODOLOGY: A total of 1,039 adult smokers, 18 years old and above were interviewed face-to-face in June 2012 within six smoke free zones. Attitudeof smoker before and after implementation were measured by similar question: “I will describe some situations and if you think you would not smoke, please tellme”. Changes of attitudes reported by smokers were recorded before and after the implementation of the project in different social settings.
RESULTS: Implementation of the policy resulted in significantly higher number of smokers committing to not smoking in many of the situations listed below:
if non-smokers are present (from 44% before the implementation of policy to 60% after the implementation), if a non-smoking family member is present (from67% before to 77% after the implementation), if an older non-smoking person is present (from 69% before to 78% after the implementation), if a policy officer
or by-law officer is present (from 83% before to 87% after the implementation), if other smokers are present (from 14% before to 27% after the implementation)and if there is visible signage reminding you that it is a smoke-free area (from 70% before to 75% after the implementation). The number of smokers not smoking
in the presence of children continues to be high before (81%) and after (83%) the implementation of this policy.
CONCLUSION: Smokers’ attitudes improved after the implementation of project by not smoking in front of children and other non-smokers in public places.
This project has shown the potential in reducing exposure to secondhand smoke in public places thus protect the non-smokers.

96

S10-06

Social Marketing Campaign to Support the Implementation of the Comprehensive Smoke Free Ordinance in Selected
Pilot Provinces in the Philippines

Maria Soledad ANTONIO1, Marysol BALANE1, Bill BELLEW2, Jorge ALDAY3
Bureau of International Health Cooperation1, International Union Against Tuberculosis and Lung Diseases2, World Lung Foundation3
Background: The prevalence of current smokers in the Philippines is high at 27%. Tobacco Regulation Act had been enacted since 2003 but was hardly
implemented at the local level.
Objective: The study aimed to assess the level of knowledge of the health effects based on the campaign, attitude on the campaign effects on smoking behavior
and quit attempts and reported campaign effects on household discussion of smoking.
Methodology: Strategic communication plan was developed for each of the 12 pilot provinces and hard hitting video and materials were adapted from anothercountry, translated in six different dialects and pre-tested in the pilot provinces. Sub-national campaign implementation was done by airing six times a day for
four weeks during prime time in private and public sub-national television and radio stations, as well as, posting posters and billboards on strategic public places.
Campaign evaluation was done right after the campaign implementation using household survey with a random sample of 300 inhabitants in the province of
Nueva Vizcaya. The data was analyzed to determine campaign exposure and the association between campaign exposure and changes in the public’s knowledge
and attitudes.
Results: Results of the survey showed the “Cigarettes Are Eating You Alive” campaign, was seen by 58% in television and in posters or billboards while 44%
heard the radio ad used in the campaign. 95% of those who saw and heard the ad agreed that it provided new information to them, 85% agreed that it made themstop and think, 63% discussed it with others while 65% tried to persuade others to quit. Among smokers who saw the ad, 95% agreed that the ad made themconcerned about the effect of smoking to their health while 89% became concerned about the effects of smoking to their family’s health. 61% of smokers said
the ad made them more likely to quit.
Conclusions: The social marketing campaign in selected pilot provinces had been relatively successful in reinforcing public knowledge and attitudes that favor
the smoke-free ordinance of the provinces. It had also helped in increasing awareness about the harms of smoking and making the public more concerned about
the effects of smoking to their health.

S11-01De-bunking the Myths of Tobacco Taxation

Hana ROSS
American Cancer Society
Tobacco industry is using libertarian and economic arguments against any tobacco control effort, and particularly against tobacco tax increases, in order to divert
attention away from the health consequences of tobacco use and to protect the tobacco industry profits. The industry claims that higher tobacco taxes will notbring more revenue due to tax avoidance and tax evasion.
However, the research shows that:
1. there are many factors that motivate tax avoidance and tax evasion, and tax is not the most important one.
2. tobacco tax increase will result in higher government revenues, and better public health despite the presence of illicit tobacco trade.
3. the tobacco industry itself has been implicated in tobacco smuggling
The tobacco industry also stipulates that higher tobacco taxes are unfair because they primarily burden the poor.
However, the research shows that:
1. The majority of the additional tobacco tax revenue after a tax increase comes from the rich, and
2. The poor decrease consumption more relative to the rich.
Therefore, the poor will enjoy more health benefits, and reduce the costs associated with smoking more than the rich.
Higher tobacco taxes will not harm the economy. The tobacco business is not vital for any country’s economic performance. If there is no tobacco business,the money currently spent on tobacco will be spent on other goods and services, thus creating jobs and business opportunities in other sectors of the economy.
On the other hand, there are many negative consequences of tobacco business. The arable land currently devoted to tobacco cultivation could feed 10–20 million
people. And tobacco trade has often a negative impact on the balance of payments.
Health is a central issue for sustainable development. Therefore tobacco control measures, and particularly tobacco tax increases are an important component of
the development agenda.

S11-02

Application of Korea SimSmoke to Develop Tobacco Control Strategies

Sung-il CHO
Seoul National University Graduate School of Public HealthObjectives: Korean government has set a goal to reduce male smoking from current level of 47% to 29% or below by 2020. To achieve this goal, strong andeffective tobacco control is required. Developing policy strategy can benefit from prediction of the results attainable by different options. Standard statisticalmethods are limited in such prediction because of nonlinearity of policy effects. We utilized a simulation model, SimSmoke, adapted to Korean context to assess
various policy scenarios and developed key strategies to meet tobacco control policy goals.
Methods: SimSmoke simulation model utilizes discrete time Markov process to predict future population and smoking prevalence. This model has been applied
to many countries previously. We developed Korea SimSmoke model based on Korea National Health and Nutrition Examination Survey (KNHANES) from1995-2005. Effects of various policy combinations on future smoking prevalence were compared. Following MPOWER framework by WHO, policy areas are
categorized as protecting from smoke(P), offering help(O), warning(W), enforcing bans(E), and raising price(R).
Results: Application of Korea SimSmoke model suggests that 2020 goal can be achieved only by combining both price and non-price policies. A raise of $2 in
tobacco price combined with strong non-price policies is necessary. For non-price policies, maximum strengthening of P,O,W,E in combination is necessary,
unless price is increased far beyond $2.
Conclusion: Tobacco control policy in Korea is currently facing a great challenge with high male smoking prevalence. A significant raise in tobacco price by $2
combined with strengthening of other non-price policies is expected to successfully reduce male smoking to meet the 2020 policy goal.

97

S11-03

Effectiveness of Tobacco Tax and Price Policies for Tobacco Control

Frank J. CHALOUPKA
University of Illinois
Extensive economic research has documented the impact of tobacco product taxes and prices on tobacco use. This presentation will highlight the key findings
from this research, drawing upon the global evidence base and highlighting findings from the IARC Handbook Effectiveness of Tax and Price Policies for
Tobacco Control. This large and growing evidence base clearly shows that increases in tobacco product taxes and prices lead to reductions in overall tobaccouse, including both the prevalence and intensity of tobacco use. In addition, tax and price increase lead adult tobacco users to quit and prevent young people fromtaking up tobacco use. Additionally, recent research has helped to identify best practices in tobacco taxation - those that maximize the public health impact of
tobacco taxes while at the same time generating increases in tobacco tax revenues in the short to medium term. This includes research on the role of tax and pricein reducing the affordability of tobacco products and on tax structure. Findings from this recent research will be discussed and 'best practices' in tobacco taxation
identified. Finally, other effects of increased tobacco taxes, including their impact on revenue, tax avoidance and evasion, and employment, will be reviewed.

S11-04

The Distribution of Cigarette Prices in Different Tax Structures: Findings from the International Tobacco Control Policy
Evaluation (ITC) Project

Ce SHANG1, Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Nahleen ZAHRA1
University of Illinois1, University of Waterloo2, Ontario Institute for Cancer Research3
Background: The distribution of cigarette prices has been rarely studied and compared among different tax structures. Descriptive evidences on the pricedistribution by countries might shed some light on opportunities for tax avoidance and brand switching in different tax structures, which could reduce theeffectiveness of taxation on reducing smoking.
Objective: This paper aims to describe the distribution of cigarette prices by countries, and compare these distributions by tax structures.
Methods: We employed data for 16 countries taken from the International Tobacco Control Policy Evaluation (ITC) Project to construct survey-derived cigaretteprices for each country. These prices were weighted by cigarette consumption and described using a comprehensive set of descriptive statistics. We further
compared these statistics for cigarette prices among different tax structures. In particular, countries that are close in region or the amount of total excise taxes yet
impose different tax structures were paired and compared in mean and variance using two-sample comparison test.
Findings: Our investigation illustrates that compared with exclusively specific taxation, other tax structures (exclusively ad valorem, and the mixture of advalorem and specific taxation) tend to have price distributions with larger standard deviation. And compared with uniform taxation, tiered taxation tends tohave price distributions with larger standard deviation. Countries that heavily rely on ad valorem and tiered taxes tend to have wider price distribution aroundthe median. Among mixed taxation systems, the selected countries that rely more heavily on the ad valorem component tend to have prices of larger standard
deviation than countries that rely more heavily on the specific component. In countries with tiered tax systems, cigarette prices are more skewed to lower prices
than those in uniform systems. The analyses presented here demonstrate that there exist more opportunities for tax avoidance and brand switching when tax
structure does not largely rely on uniform or specific taxes.

S11-05

Industry’s Response to Tax Increases: Price Subsidies Under Different Tax Systems and Consequences for Government
Tax Revenues and Public Health

Nigar NARGIS1,2, Ayda YUREKLI1World Health Organization1, University of Dhaka2
Under globalization, the world tobacco market has been shared by five major companies, where four are the multinational tobacco companies, namely Philip
Morris International, British American Tobacco, Japan Tobacco international and Imperial Tobacco. Consequently, each company has brands serving different
price segment of the market from premium to economy bands. It is generally expected that the industry would shift the burden of higher tax to consumers byraising price, which in turn would reduce consumption and improve public health. Under inelastic market demand and low share of tax in price, the increase intax results in higher tax revenue for the government, at least in the short to medium term, even after the reduction in demand. However, depending on the market
share of companies by price band and also concentration of demand in price segments, industry’s response to tax increases could vary. Without jeopardizing
expected revenues, industry may choose to increase the price at the higher price segment and subsidize some of their most popular brand(s) in lower pricesegments in order to alleviate the tax impact in that segment. This is expected because consumers at the lower price segment tend to be more price-sensitive andthe industry may want to keep the price level in that segment from going up in order to maintain the market size and profit generated at the levels existing prior
to the tax increase. In this paper, we will examine the likelihood of price subsidies under different tax systems (ad valorem and specific) and their consequences
for the government tax revenues and public health. For this purpose, we will apply the tax simulation model of the World Health Organization Tobacco Control
Economics Unit. Our conjecture is that the price subsidy will have differential impact on the price level and demand at different price band of tobacco products.
This type of pricing scheme adopted by the industry is likely to undermine the intended impact of tax and price increase on tobacco consumption that havenegative consequences for both public health and tax revenues.

98S11-06

Coordinated Advocacy Campaign to Increase Subnational Taxes in India

Vandana SHAH1, Sanjay SETH1, Virendra SINGH3, Satyen CHATURVEDI2, Jaspreet PAL1, Hema KHANCHANDANI1Campaign for Tobacco Free Kids1, Rajasthan Voluntary Health Association2, Indian Asthma Care Society3
Background: Over the past two years, a large number of Indian states have significantly increased the VAT on cigarettes, bidis and smokeless products, whichhave produced a significant income. Much of this can be attributed to a aggressive and coordinate advocacy by civil society organization devising a series ofstrategies.
Objectives and methods: A series of activities were carefully planned to successfully increase tobacco taxes across multiple states. At the state level, thefollowing activities were carried out: 1) political Mapping; 2) gaining entry and engaging policymakers; 3) developing and delivering key messaging topolicymakers; 4) mobilizing key stakeholders; 5) holding policymakers accountable; 6) following up with key stakeholders.7) using media effectively after thetax increases to prevent any backtracking under industry pressure
Results: As a result of extensive advocacy efforts, taxes have been increased 25 times across 18 Indian states in a span of two years. Data from some state tax
commissioners also show that revenues have increased proportionately to the tax rates.
Conclusions: Though tobacco control is a health issue, it is important to engage key financial figures and state leaders in order to secure effective tobacco tax
rates across all products.

S12-01

Quit History, Intentions to Quit, and Reasons for Considering Quitting among Tobacco Users in India: Findings from the
Wave 1 TCP India Survey (2010–11)

Gauri G. DHUMAL1, Mangesh S. PEDNEKAR1, Lalit J. RAUTE1, Prakash C. GUPTA1, Genevieve SANSONE2, Anne QUAH1, Geoffrey T. FONG2,3
Healis Sekhsaria Institute for Public Health1, University of Waterloo2, Ontario Institute for Cancer Research3
Background: GATS India 2009-10 revealed that more than one-third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke,and 5% are dual users (they smoke and use smokeless tobacco), and the quit rate is very low. It is thus important to understand the factors that are related to future
quitting among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports theprevalence of past quit attempts, current intentions to quit, and reasons for thinking about quitting in four Indian states.
Methods: Data from the Wave 1, cross sectional phase of the International Tobacco Control (TCP) India Survey, a longitudinal cohort study conducted in fourstates: Maharashtra, Bihar, Madhya Pradesh, and West Bengal between August 2010 and October 2011 are analyzed. A total of 8051 adult tobacco users (15+years) were randomly sampled from 8586 households: 1255 smokers, 5991 smokeless users, and 805 dual (smoke and smokeless) users. Respondents weresurveyed using validated, standardized questionnaires where they were asked about current tobacco use, intention to quit, and attempt to quit tobacco products.
Results: 26.8% of the smokers, 24.8% of smokeless tobacco users, and 15.9% of the dual tobacco users had ever made a serious attempt to quit. Only 13.7%
of smokers, 16.3% of smokeless users, and 15.0% of dual tobacco users reported having any intention to quit within the next 6 month or sometimes in a future.
Tobacco users in Madhya Pradesh were least likely to intend to quit (5.2% of smokers, 6.0% of smokeless users, and 4.9% of dual users), and tobacco users in
Maharashtra were most likely to intend to quit (22.2% of smokers, 21.7% of smokeless users, and 27.4% of dual users). “Personal health concerns” was the mostcommon reason for thinking about quitting (92.4%); “setting an example for children” was the second most common reason (58.4%). 26.4% of tobacco users
had visited doctors/health professionals in the last 6 months; of these, 47.1% were advised to quit, and for 67.4% of those, this advice led to thoughts of quitting.
Conclusion: These findings document the very low levels of quit attempts and of intentions to quit, which point to the formidable challenges facing India toreduce tobacco use. Fewer than one in four tobacco users have ever attempted to quit (compared to over 80% in many high-income countries) and fewer than one
in six intend to quit (compared to over 70% in high-income countries). The reasons given for considering quitting are similar to those of other countries. Thesefindings point to the urgent need for public information and policy action to promote quitting in India.
Key Words: TCP India Survey, cessation, tobacco, intentions to quit

S12-02

Smokeless Tobacco Products and Tobacco Imitations in Japan

Masaaki YAMAOKA
Sumoto Energicenter
In Japan there are some kinds of Smokeless tobacco products and Tobacco Imitations.
Smokeless tobacco products.
In 1985, a smokeless tobacco product was imported and sold for the first time in Japan. In 2003, a new chewing tobacco "FIREBREAK", which was produced
Dualof smokeless
Imitation
harmfuleffect finallyandby Swedish Match Inc., was imported and began tosell. use
However,
in 2009, the tobacco
adversive productmovementand
by aTobacco
citizen groupand the has
opinionof specialists
made them disappear from the market. In 2010, Japan
Tobacco Inc.(JT)beganwithto sella newsmokelesstobacco, "itZERO
STYLE
MINT people". After that,
JT hasbeen
possibility
to interfere
quit
smoking.
Moreover,is easy
for youngto usethem.
producing new 4 smokeless tobacco products such as "ZERO STYLE BITTER" but each of them contains about twice amount of nicotine as "ZERO STYLE
In Japan, fortunately, these products aren't so popular yet, but in future, we need an
MINT" contains. In addition to that, in Japan, anyone can buy smokeless tobaccos such as SNUS at internet stores without his age checked.
attention sufficiently.
Tobacco Imitations.
They are similar to tobaccos but not made from tobacco leaves. These are sold to help quit smoking. "NEOCEADAR" was authorized as a cough medicine forsmokers and started being sold in 1960. However, in 2001, it was reported that “NEOCEADAR " was containing nicotine and tar, and was able to be addictive.
I established an Internet website and started researching information about “NEOCEADAR “addicts in 2001. Afterthat I analyzed 31 addicts. The virtues of "NEOCEADAR" say people shouldn’t take more than ten of them, but the
average consumption of those addicts was 22.5 a day. Substantively, "NEOCEADAR" is "Tobacco". “KIN-EN-SO"
was used as a medicine help people stop smoking. It is said that the proper way to use this is declaring the amountgradually day by day, however, there is no evidence that show the smoke of “KIN-EN-SO" is helpful for quitting
smoking. In Japan, nicotine-including electronic cigarettes are illegal, however, are in the market so far. Dual use of
smokeless tobacco product and Tobacco Imitation has harmful effect and possibility to interfere with quit smoking.
Moreover, it is easy for young people to use them. In Japan, fortunately, these products aren't so popular yet, but infuture, we need an attention sufficiently.

99S12-03

Areca Nut Epidemic among School Children in Mumbai, India

Nikita SURANI1, Ajay PILANKAR1, Devika CHADHA1, Tshering BHUTIA1, Vaibhav THAWAL2
Salaam Bombay Foundation1, Narotam Sekhsaria Foundation2
Context: Tobacco is a known cause of cancers which claims many lives. Many states in India are now banning the sale and marketing of tobacco especiallythe smokeless variety, resulting in a tussle between the tobacco industry on one hand, and the government and civil society organizations on the other. Tobaccocompanies have been notorious for surrogate selling of their deadly products. They are now resorting to the manufacturing, marketing, and sale of areca nut
which are as harmful as tobacco products, but do not contain tobacco as an ingredient. Oral malignancy and its precursors among 'areca nut' users, with adding
tobacco increasing risk, claims young lives. Very few studies attempt to find the pattern of areca nut use, especially among school children and guide cessationinterventions to curb the deadly product.
Aims: The study aims to find areca nut prevalence among school children in Mumbai.
Settings and Design: A pilot study was conducted in three municipal schools in Mumbai. A brief cross-sectional interviewer-administered survey wasadministered to the students by trained field investigators.
Methods and Materials: A survey of 1,683 fifth to tenth grade students studying in three municipal schools in Mumbai was conducted.
Results: 27.2% students consumed areca nut, 2.3% consumed tobacco, 0.8% consumed both, and 0.6% consumed paan / paan masala. “Ritik” and “Mogali”
were the most popular areca nut brands used. Areca nut use was higher among males compared to females (38.1% vs 9%), and in higher grades compared tolower grades (29% vs 23.9%). 40.1% students in school A, 22.3% in school B, 24% in school C used areca nut. 5.4% students cited peer pressure as the reason
for areca nut / tobacco use.
Conclusion: High areca nut use among children is a cause of concern. School-based oral screenings to identify “at risk” students should be conducted, followedby male focused cessation efforts through group counseling, and advocacy to curb the sale of areca nut especially to school children.

S12-04Comparison of Characteristics of E-Cigarette Only Users and Dual Users of Both Cigarettes and E-cigarettes Among
Korean Adolescents

Eun Young KIM1, Sun Ha JEE2, Dae Yong KANG2, Ji Eun YOON3
Korea University1, Yonsei University2, National Rehabilitation Center3
Objectives: To compare characteristics of e-cigarette only users and dual users of both cigarettes and e-cigarettes among Korean adolescents.
Methods: Data from a nationally representative self-reported data, the 2011 Korean Youth Risk Behavior Web-based Survey (n=75,643) was obtained. The
participants of the survey were middle and high school students in grade 7th-12th (aged 13-18 years)
Results: The prevalence of cigarette only smokers, e-cigarette only users, and dual users of both products were 8.6%, 1.1% and 3.3%, respectively. Sex, grade
and school achievement were associated with dual use of cigarette and e-cigarettes among Korean youth. Grade, school achievement, subjective happinessand level of mother's education were significantly related to the use of e-cigarettes. The results from regressions show that: younger students (OR .73; CI .60.89); students who had higher health concerns (OR 1.13; CI 1.02-1.27); students who had higher school achievements (OR 1.17; CI 1.08-1.26); students who
had higher subjective happiness (OR 1.12; CI 1.01-1.25); and students whose mother had higher education level (OR 1.30, CI 1.11-1.53) were more likely touse e-cigarette only. Meanwhile, boys (OR 2.37; CI 2.05-2.74), students who had lower school achievements (OR .89; CI .85-.94), students who had higher
perception of depressive symptom (OR 1.18; CI 1.05-1.33), students who had higher alcohol drinking (OR 1.24; CI 1.10-1.39), and students who had higher druguse (OR 2.10; CI 1.64-2.70) were more likely to use both cigarettes and e-cigarettes.
Conclusions: E-cigarettes are widely advertized on the Internet and magazines as a smoking cessation aid in Korea. Our findings support the argument thate-cigarette advertisement affects health behavior among Korean youth. Because students who were less likely to use conventional cigarettes were more likely touse e-cigarettes, which means Korean youth probably did not recognize e-cigarettes as harmful products. The current cigarette smokers among youth also tried
to use e-cigarettes. Dual use of both cigarettes and other tobacco product can threaten public health, therefore, until there are further research on e-cigarettes’safety, health experts and the government continue to monitor e-cigarette use among youth and control the industry’s marketing practice.

S12-05The Current Status and Regulatory System of Electronic Cigarette in Korea

Cheol Min LEE
Seoul National University Hospital
Electronic cigarettes (E-cig) developed by Hon Lik, Chinese pharmacist, intended to reduce concentrations of toxic compounds in mainstream and side stream
smoke and to help smokers give up. They are battery powered devices that stimulate tobacco cigarettes by vaporizing nicotine and other chemicals into an
inhalable vapor. World Health Organization named this as electronic nicotine delivery system (ENDS), and recommended that ENDS products should be
regulated as combination drugs and medical devices and not as tobacco products. In spite of relatively short history of E-cig in Korea (in the market after 2008),
they have been widely used especially in adolescent and smokers who want to quit). Because of the fact that ENDS might facilitate and perpetuate nicotine
addiction, claims that ENDS assist smoking cessation should be prohibited, unless the efficacy of these devices, when used as intended, is scientifically provento the satisfaction of regulatory authorities. More rigorous chemical analyses are needed, followed by extensive research involving animal studies and, finallyclinical trials in humans. According to the Korean report in 2012 to analyze 121 liquid phases of E-cig being sold in Korea market by gas chromatographyspectrometry, the levels of nicotine to vary even in cartridges whose label claim to have the same amount of nicotine. Until these crucial implementation stages
are completed, physicians and other healthcare professionals must inform consumers of the probable risk of the claims of manufactures of electronic cigarettes.
In this presentation, I will explain the current status and the pitfall of the regulatory system of E-cig in Korea. Using data from the 2011 and 2012 Korean YouthRisk behavior Web-based Survey, I will also show how many Korean adolescents are exposed to E-cig and the socioeconomic characteristics of E-cig users.
Keyword: Electronic cigarette100S13-01

Daring to Dream: Policy-makers and Practitioners’ Views of an ‘Endgame’ Solution to Tobacco Smoking at a Country
Level

Richard EDWARDS1, Jo PEACE1, Marie RUSSELL1, Heather GIFFORD2, George THOMSON1, Nick WILSON1
University of Otago1, Whakauae Research2
Background and aim: The New Zealand (NZ) Government has adopted the goal of making NZ smokefree by 2025. Achieving this is likely to require bold andinnovative ‘end-game’ solutions. We explored with policy-makers and public health and health promotion practitioners their views about the vision of a smokefree NZ and one of the possible means to achieve it - the creation of a not-for-profit tobacco product distribution agency (regulated market model).
Methods: We carried out 3 focus groups with policy-makers and public health experts (total participants =16). At the start of each focus group we gave a 20
minute presentation which set out the extent of the public health problem posed by tobacco in NZ, and outlined the vision of a tobacco free country by 2020 inwhich children would be free from exposure to tobacco and smoking prevalence is close to zero. We argued that new approaches would be needed, and that one
such approach was a Tobacco-Free Commission. This was described as a semi-autonomous not for profit government agency with a public health mandate which
would act as a monopoly purchaser and distributor of tobacco products. It would control the supply of tobacco and facilitate and promote measures to reducesmoking prevalence. The focus group discussions were analysed using thematic analysis.
Results: We successfully communicated the concept of a regulated market and a “Tobacco-free Commission” to practitioners and policy-makers, who were
mostly supportive of the vision and intrigued by the regulated market model. However, they also identified a range of potential implementation problems. A key
theme was the need to frame tobacco appropriately if radical endgame solutions are to be politically feasible.
Conclusions: The findings of somewhat guarded support contrasted with previously reported more positive responses found when this approach wascommunicated to and discussed with members of the public (smokers and non-smokers).
The study provides insight into possible barriers to implementation and ideas how smokefree goals and endgame
solutions might be communicated to key
Tobacco litigation significantly affects the implementation and development ofcomprehensive tobacco
controlsolutions.
policies and measures.
It is certain shouldthat providing
stakeholders. The findings suggest that a credible rationale for radical action is needed to support he implementationof suchThis rationale
valuable evidence and information to the judges of tobacco litigation and the public
include a clear and credible vision for a tobacco-free future, and clear framing of tobacco as a hazardous andaddictive
and iswholly
preventable
regardingissues inproducttobacco litigationa vital publichealth concern.cause of
The present study searched and analyzed the formerly confidential
major public health harm.
documents of transnational tobacco companies that had penetrated South Korea

S13-02

since
1988
from
LegacyTobaccoDocument
Library(LTDL:
http://legacy.library.ucsf.edu/) in order to investigate KT&G’s nicotine manipulation
through additives which has been the most important argument during the Korean
tobacco litigation.
After liberalization in Korea’s tobacco market, transnational tobaccocompanies initially went through difficulty in creating demand for their brands. To
overcome this, the companies targeted a particular population, especially the young
generation as a main consumer group, and developed distribution routes for theirbrands with cigarette vending machines. In addition, the study found thattransnational tobacco companies conducted ingredient analysis of KT&G’s cigarettebrands which dominated most of the market share at that time in order to develop
similar products as them. The result of ingredient analysis shows that KT&G’s brands
included ammonia, which helps deliver nicotine quickly to the brain. “Lighter”
cigarettes did not contain a lower tar or nicotine as we expected, in fact, tar andnicotine in lighter cigarettes were similar with that of regular brands. Once the firsttobacco litigation occurred in 1999, KT&G immediately got in contact with its
competitor, Phillip Morris Asia to ask for their advice on tobacco litigation.
The findings of this study argue that there is a possibility that KT&G’s tobaccobrands included ammonia, one of the additives to be used for nicotine manipulation.
Therefore, the current and future court for Korean tobacco litigation should carefully
take into consideration the tobacco additives and tobacco industry’s nicotine
manipulation before making a judgment. More importantly, the study found that there
has been collaboration between tobacco companies on tobacco litigation. Hence, thecourt and the public health experts should monitor tobacco industry’s tactics andpractices while tobacco litigation is in progress.

Tobacco Litigation in South Korea: the Possibility of KT&G Nicotine Manipulation

Sungkyu LEE , Jaehyung KIM1, Il-Soon KIM2
University of California1, Korean Association of Smoking or Health2
1

Tobacco litigation significantly affects the implementation and development of comprehensive tobacco control policies and measures. It is certain that providing
valuable evidence and information to the judges of tobacco litigation and the public regarding issues in tobacco litigation is a vital public health concern.
The present study searched and analyzed the formerly confidential documents of transnational tobacco companies that had penetrated South Korea since 1988
from Legacy Tobacco Document Library (LTDL: http://legacy.library.ucsf.edu/) in order to investigate KT&G’s nicotine manipulation through additives which
has been the most important argument during the Korean tobacco litigation.
After liberalization in Korea’s tobacco market, transnational tobacco companies initially went through difficulty in creating demand for their brands. To overcome
this, the companies targeted a particular population, especially the young generation as a main consumer group, and developed distribution routes for their brands
with cigarette vending machines. In addition, the study found that transnational tobacco companies conducted ingredient analysis of KT&G’s cigarette brands
which dominated most of the market share at that time in order to develop similar products as them. The
result of ingredient analysis shows that KT&G’s brands included ammonia, which helps deliver nicotine Figure 1: Chemicals in KT&G’s cigarette brands
quickly to the brain. “Lighter” cigarettes did not contain a lower tar or nicotine as we expected, in fact, tar
and nicotine in lighter cigarettes were similar with that of regular brands. Once the first tobacco litigation
occurred in 1999, KT&G immediately got in contact with its competitor, Phillip Morris Asia to ask fortheir advice on tobacco litigation.
The findings of this study argue that there is a possibility that KT&G’s tobacco brands included ammonia,
one of the additives to be used for nicotine manipulation. Therefore, the current and future court for Korean
tobacco litigation should carefully take into consideration the tobacco additives and tobacco industry’s
nicotine manipulation before making a judgment. More importantly, the study found that there has beencollaboration between tobacco companies on tobacco litigation. Hence, the court and the public health Source: Reasor BA. Korea Technical Review 1998-1999/312. April 2000. British
American Tobacco. ‘Bates No.’ 325189811-39
experts should monitor tobacco industry’s tactics and practices while tobacco litigation is in progress.

S13-03

Pack Innovation and Product Designs Promoted in ASEAN Countries

Yen Lian TAN 1, Kin FOONG 2
Southeast Asia Tobacco Control Alliance1, Universiti Sains Malaysia2
Most ASEAN countries are progressively strengthening their regulation to ban tobacco advertising, promotion and sponsorship except in Indonesia which isstill in the process of imposing bans. However, the regulation does not prohibit promotion and advertising on cigarette packs and product development to enticesmokers. Tobacco industry continues to capitalize on this last platform to advertise and promote their products. This paper presents tobacco companies’tactics toadvertise and promote their products in seven ASEAN countries.
Routine surveillance at various points-of-sale was carried out across seven ASEAN countries: Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand andVietnam to monitor the introduction of new promotional innovative pack and product designs. All novelty pack and new product designs from each country werepurchased and scrutinized.
Tobacco industry in most of these countries has aggressively devised novel cigarette packaging and product designs targeting youth, children, women and men.
Innovative packs with creative graphic designs in various colours, shapes and sizes appeal to potential purchasers regardless of age groups.Colour coding wasused to sensitize consumers to the types of product design such as red colour for regular cigarette, blue for light and green for menthol.
In the absence of a ban in exotic flavoured cigarettes, tobacco industry has produced and marketedfruit flavoured cigarettes such as vanilla, strawberry, green
apple, orange in Malaysia, Philippines and Lao PDR. Confectionery (chocolate, cappuccino and tea) flavoured cigarettes weresold in Indonesia and Philippines.
Menthol and mint flavoured cigarettes are commonly found in most ASEAN countries. Tobacco industry in Malaysia and Indonesia introduced product designs
using new filter technology that comes with mint or menthol capsule. Descriptor ban in Thailand, Singapore and Malaysia led industry to use promotional texts or
terms on the pack.On contrary, a growing number of new descriptor words/terms were introduced in Indonesia, Cambodia, Lao PDR, Vietnam and the Philippines
with no descriptor ban.
Tobacco industry exploits loopholes in existing legislation across the ASEAN region. Countries are encouraged to adopt plain packaging that requires astandardized cigarette packaging removing all product advertising including colors, logos and brand imagery to effectively counter tobacco industry’s creative
packaging designs and marketing tactics that undermines measures to reduce tobacco-caused diseases.

101

S13-04

Laws Regulating Tobacco Products in Japan

Ritsu KATAYAMA
Attorney-at-law, Japan
1) Finding: No law or regulation exists in Japan focusing its attention on the content of tobacco products from the viewpoint of protecting public health. 2) Summary: (1) Laws and regulations
regarding tobacco products in Japan at present. The only law regulating tobacco products is the “Tobacco Business Law.” However the Law only provides regulation regarding the warning label(Article 39) and advertising (Article 40). There are no provisions concerning the contents of tobacco products, such as from a safety or public health perspective. Furthermore, the Minister of Finance
exercises administrative authority for this law, which exists for the maintenance of stable tax revenue from a licensing system for the manufacture and distribution of tobacco -- as set forth in Article 1:“promoting the sound development of the Japanese tobacco industry, thereby securing national revenues.“ Again, nothing in this law concerns safety or public health by regulating tobacco products.
(2) Laws and regulations in need of examination. (a) Pharmaceutical Affairs Law. The Pharmaceutical Affairs Law regulates medical pharmaceuticals. Article 2, clause 1 (3) of the law defines
pharmaceuticals as "the substances(except for ‘quasi-drugs (Iyakubugaihin) and cosmetics) that are aimed at affecting the structure or function of the body of a person or an animal, and which is nota piece of machinery nor a device of some sort."Tobacco instigates psychoactive effects (a perception of stress alleviation owing to the relief of nicotine withdrawal symptoms, et cetera) thanks to
the medicinal action of nicotine. It is a substance aimed at affecting the cells within a person’s brain. It is thus clear that tobacco falls into the above-mentioned definition of pharmaceuticals. Indeed,in the notice from the Director of the Pharmaceutical Affairs Bureau of the Ministry of Health and Welfare dated June 1, Showa 46 (1971) entitled “How to understand the list of ingredient essence(raw material) chiefly used as pharmaceuticals ", nicotine is specified as “pharmaceuticals ” due to it being “a strong toxic alkaloid" and "a substance containing specified ingredients equivalent
to a poison or powerful drug." The Poisonous and Deleterious Substances Control Act specifies nicotine as a toxic substance. Therefore, it is clear that nicotine, as a pharmaceuticals, is subject tocontrol under the Pharmaceutical Affairs Law. It is also clear that other products (nicotine patches, nicotine gum, and electronic tobacco) containing nicotine should be subjects to control under
the Pharmaceutical Affairs Law. Since the Minister of Health, Labour and Welfare has administrative authority, the possibility exists for the Act to regulate tobacco products from the viewpoint ofprotecting public health, in terms of production methods and in regards to the kind and quantity of an additive, et cetera. However, the national government has asserted in tobacco products liability
litigation that tobacco is “a socially accepted item of personal preference” and its use is a matter of choice based upon the judgment of the user. Under this assumption, the state insists that tobacco is
not pharmaceuticals as specified in the Article 2 clause 1 (3) of the Pharmaceutical Affairs Law. The courts have also determined that "As for psychoactivity, it is within the limits permitted for itemsof personal preference, so it is understood as not corresponding to the influence of the function of a person, as defined by Article 2 clause 1 (3) of the Pharmaceutical Affairs Law.” (b) Other laws
and regulations. Aside from the Pharmaceutical Affairs Law, Tobacc should also apply to the the Food Sanitation Law, as well as be considered to be included in the Act on Control of Household
Products Containing Harmful Substances. However, if according to the judgment of the Japanese Government and the courts that regulation by Pharmaceutical Affairs Law is excluded for the reason
that tobacco is “an item of personal preference," then tobacco is, in effect, only to be regulated by the Tobacco Business Law. 3) Discussion: In Japan, the Tobacco Business Law, which the Ministryof Finance exercises regulatory authority over for the purpose maintaining stable tax revenue, is currently the only law that directly regulates tobacco products. According to this law, the Japanese
government takes the stance that tax revenues in excess of 2 trillion yen per year take precedence over public health. Furthermore, the Japan Tobacco Inc.Law, Article 2, clause 1 requires the Ministerof Finance to retain government ownership of one third of the shares of JT. Regulations on tobacco products should be enacted with the purpose of protecting public health and should be under theauthority of the Minister of Health, Labour and Welfare. Under the status quo that is limited to regulations from a Finance Ministry intent on encouraging the production and sale of tobacco and themaintenance of stable tax revenue, there is little possibility for effective tobacco regulation. Since Japan has ratified the Framework Convention on Tobacco Control, This defective state of affairs
need to be resolved at the earliest possible moment, not only to protect public health, but in accordance with Japan’s national obligations as a party to the Framework Convention on Tobacco Control.

S13-05Denormalizing the Tobacco Industry One Campaign at a Time

Miranda WANG, Yiqun WU
Campaign for Tobacco-Free Kids, Thinktank Research Center for Health Development, Chinese Association on Tobacco Control
Building momentum for tobacco control requires simultaneous efforts to change society’s positive view of the tobacco industry. From the giving of cigarettes
as gifts to awarding tobacco companies for their services, the Chinese tobacco industry is well integrated into Chinese culture. Tobacco control groups, such as
Thinktank Research Center for Health Development and the Chinese Association on Tobacco Control (CATC), constantly monitor the tobacco environment inorder to discredit, preempt, and/or counter activities that may serve to promote the industry. In 2013, Thinktank launched a new tobacco industry accountability
project to systematically counter the Chinese tobacco industry and promote tobacco control. This presentation will cover the mechanisms used by both Thinktank
and CATC to change alter society’s positive view of the Chinese tobacco industry. It will also describe the overall complementary strategies used by theorganizations that successfully undercut the tobacco industry. The presentation will highlight the lessons learned from their campaigns to: a) remove industry
sponsorship of “Black Tiger” events that covertly promoted “Black Tiger” tobacco; b) block a national scientific award to a Chinese tobacco industry scientist
that would legitimize claims of a ‘lower harm’ cigarette technology; and c) remove industry sponsorship of primary schools that serve to promote cigarette brands
to kids. Following the presentation, participants will have a broader understanding of the tobacco control environment in China and the tactics used by advocatesto fight the tobacco industry.

S14-01

End Tobacco Industry Corporate Giving

Mary Assunta KOLANDAISoutheast Asia Tobacco Control Alliance (SEATCA)
The World Health Organisation refers to the tobacco industry’s corporate responsibility (CSR) activities as an “inherent contradiction”. Tobacco is unlike otherproducts in that it is the only product that kills half its regular users prematurely. The global tobacco treaty, the WHO Framework Convention on Tobacco
Control (FCTC), ratified by 177 Parties, states in its Article 13 Guidelines, Parties should ban contributions from tobacco companies to any entity for “socially
responsible causes”, as this is sponsorship. The Guidelines also state publicity given to “socially responsible” business practices of the tobacco industry should
be banned. Most countries in the ASEAN region have banned tobacco advertising, sponsorship and promotions but not CSR activities. This presentation explores
the CSR activities of the top three transnational tobacco companies (TTCs) in ASEAN region, challenges facing governments and recommendations.
Methods: CSR activities by the tobacco industry between 2009 and 2012 were identified using monitoring tools developed by the Southeast Asia Tobacco
Control Alliance (www.seatca.org). The information was then triangulated with relevant information from tobacco industry reports on CSR activities and FCTC
compliance reports of the ASEAN countries.
Results: CSR activities by TTCs were found in five countries with Indonesia and Philippines and registering the most number. Activities were mainly in poverty
reduction and community projects, education related programmes involving schools and students, and art, culture and sports.
Philip Morris International conducted CSR activities focused on poverty reduction such as micro entrepreneurship in rural communities, scholarships to youth
for education, and environmental projects. Of its 64 projects covering 5 countries, nearly half were in Indonesia. Indonesia is the only country in Asia that has not
ratified the FCTC and has the weakest tobacco control measures. A commonality among these activities are “rural poor” a constituency that has high patronage
among politicians. Funding government programmes focused on poverty eradication will earn TTCs political mileage. Countries receiving the most CSR,
Indonesia and the Philippines, also have the weakest tobacco control regulations.
Conclusion: Choice of CSR activities benefits the tobacco industry’s own constituency. TCCs use CSR activities to thwart or delay regulation of their industry
and implementation of tobacco control. Since ASEAN countries are obliged to prohibit CSR activities by the tobacco industry, banning the publicity to CSR
would be a good start.

102

S14-02

The CSR Conducted by Tobacco Companies in Japan

Masako SHIGETA1,2, Isao WATANABE1, Daisuke MATSUI1,Kaoru INOUE1, Nahomi MIKAMOTO1, Atsuko AOKI2, Takashi DOI2, Narito KURIOKA2,
Tadaaki MORI2, Yuji YASUDA2
Kyoto Prefectural University of Medicine1, Kyoto Association for Tobacco Control2[Background] The tobacco industry carries out plenty of activities in the name of corporate social responsibility (CSR) in Japan. Because the manufacture andsale of tobacco had been a government monopoly enterprise until 1985 and the largest tobacco company (Japan Tobacco; JT) took over the monopoly entirely.
Even today Japan government owns one third of stock of JT. Moreover tobacco industries (JT, Phillip Morris; PM and British American Tobacco; BAT) havemore than enough money to conduct such CSR activities.
[Purpose] The CSR conducted by tobacco companies in Japan includes diverse strategies which are integrated into the community. Sharing the situation shouldbe very useful especially for people in developing countries and Japan who are generally naïve about their strategies. Therefore we compiled a list of theiractivities and categorized them by their objective.
[Methods] We collected the CSR activities conducted by JT and PM through their website and categorized according to the following criteria; [1] to dilute hostile
feelings from non-smokers, [2] to prevent current smokers from quitting, [3] to improve the image of tobacco industry,[4] to affect decisions by administrators
for tobacco control. Some anti-tobacco groups mounted a protest to administrators. We describe the process and the results.
[Results] To dilute hostile feeling from non-smokers, JT has been conducting “improve the manners of smokers” campaign. To prevent smokers from quitting,both JT and PM have been making smoking booths in public areas, especially at the station plazas. To improve their image JT has been conducting cleanup
activity in all over the Japan and supporting the Volley ball World cup, local orchestra, children’s Shogi championship, tree planting, and so on. PM has been
conducting anti domestic violence campaign and child abuse prevention campaign. Some anti-tobacco groups have complained to local governments, however,most of the authorities ignored the complaints or responded formally.
[Discussion] The CSR activities seem benevolent to societies superficially and JT showcases them in TV commercials which can influence the decision of
citizens. We should highlight the true nature of the activities forcefully.

S14-03

Saveourfarmer.org Website to Counter Tobacco Farming Front Groups

Jennie L. REYES, Sophapan RATANACHEASoutheast Asia Tobacco Control Alliance
Save Our Farmer (www.saveourfarmer.org) is a regional campaign of the Southeast Asia Tobacco Control Alliance (SEATCA) in response to mounting efforts
of tobacco industry front groups, primarily the International Tobacco Growers Association (ITGA) to mislead the public and create fear among tobacco farmers
worldwide in order to promote the interests of the tobacco industry and curtail the implementation of the WHO Framework Convention on Tobacco Control.
While tobacco consumption and production have reached alarming proportions in developing nations, claims of prosperity from tobacco cultivation by tobaccocompanies deliberately obscure the downsides of tobacco farming. Across Southeast Asia, the number of farmers employed in tobacco farming is small comparedto overall national employment. However, tobacco companies continue to argue for tobacco farming’s creation of jobs. Revenues from tobacco may appear
advantageous to both farmers and national governments but the cost entailed in farming tobacco is also high relative to other crops. Declines in tobacco
farm productivity, low fetching prices for crop, indebtedness, exposure to health and environmental hazards put tobacco farmers and their families at a clear
disadvantage. Governments also do not substantially earn from tobacco production – as revenues fall behind the projected amounts. Many countries are also net
importers of tobacco leaf, losing millions of dollars each year in foreign exchange. In the end, only the transnational companies reap the greatest benefits fromtobacco farming.
The SaveOurFarmer website is a tool to counter tobacco industry front groups. The website aims to monitor press releases and other media activities by the
tobacco industry and its front groups and to counter the arguments and lies spread by the industry specifically on tobacco farming, featuring video testimonies oftobacco farmers, up-to-date researches, and country information to refute industry claims related to tobacco farming.

S14-04

Tracking Investments by Financial Institutions in Tobacco Companies - What Tobacco Control Advocates Need to Knowand Do about It?

Pranay LAL
International Union Against Tuberculosis and Lung Disease
Background and Objective: Roughly €3 trillion in assets and investments are managed by socially responsible investment (SRI) funds worldwide which
motivate institutional investors to take a more stringent view on ethical investing. Ethical investing include not investing in tobacco industry or its stocks.
Tobacco is a cross-cutting area where such investments are forbidden. Tracking investments made by governments and private financial investors in the tobacco
sector can influence in mitigating the proliferation of the industry in the future.
Methods: This research examines investments made by the largest private banks in the world which conform to SRI standards using customised, paid for banking
databases.
Results: The analysis finds that 42 of the top 50 global bank invest and support tobacco industry domestically and in offshore projects.
Conclusion: Definition of socially responsible investments within the perspective of screening tobacco investments is perceived variably by financial institutions.
Also in the absence of a watchdog institution and few disincentives for truant behaviour, investors continue to invest tobacco companies. Tobacco control
advocates need to monitor investments made by large banks and institutions in tobacco industry and ensure that banks which have committed to SRI codes
conform to them.

103

promotions within cigarette retail shops and magazines and sponsorship of social,
cultural, musical, athletic, and other specific events.
In 2003, KT&G created “KT&G Sangsang Univ.”. The word, “Sangsang(상상)”means “imagination.” Even though it is called a “Univ.”, KT&G Sangsang Univ. is nota university; it appears to be part of KT&G. KT&G Sangsang Univ. reinforces KT&G’s
corporate social responsibility (CSR) activities. However, its primary function is toserve as a marketing activity to approach Korean college students aged 19-27 who
belong to the highest smoking rate group. (The smoking rate of Korean young adults
aged 20-29 year olds is 53% in men and 11.6% in women.) One of the key
programmes run by KT&G Sangsang Univ. is a six or seven week marketing classhighlighting KT&G’s tobacco marketing strategies (e.g., building brand image,defining target groups, designing product packaging) and its particular tobaccobrands as teaching exemplars (Figure 1). Upon completion students receive a formal
Sungkyu LEE, Stanton A GLANTZ
certificate from KT&G Sangsang Univ., potentially increasing their post-college
marketability. Although the current tobacco-related regulations in Korea restrict
University of California
advertising of tobacco brands to cigarette retail shops and specific magazines, themarketing class of KT&G Sangsang Univ. enjoys unregulated use of company brandEver since South Korea opened its tobacco market to the transnational tobacco companies’ (TTCs) in
1988, KT&G (Korea Tomorrow & Global), the nowimages.
Previous researchfound thatoutdoor
tobacco industry
CSR freeactivities
are used to
privatised state tobacco monopoly, has steadily lost market share. Korea restricts cigarette advertising and marketing,prohibiting
signage,sampling
the social unacceptability of tobacco and smoking, re-build company
outdoors, and advertisements in TV, radio, and newspapers, while allowing cigarette promotions withinovercome
cigarette
retail shops and magazines and sponsorship ofcredibility, improve employee morale, and secure access to policymakers. In additionsocial, cultural, musical, athletic, and other specific events.
to these functions, KT&G Sangsang Univ. has expanded the scope of CSR activities
to supporting
KT&G marketing,includingpromotion.
Becausethe place of the
In 2003, KT&G created “KT&G Sangsang Univ.”. The word, “Sangsang(상상)” means “imagination.”
Even though
it is calleda brand“Univ.”,
KT&G
Sangsangmarketing course is not a cigarette retail shop and many of the “students” in KT&G
Univ. is not a university; it appears to be part of KT&G. KT&G Sangsang Univ. reinforces KT&G’s corporate
responsibility(CSR)
activities.
However,
its
Sangsangsocial
Univ. arewomen, its activities
appearas a loopholein Korea’s tobacco
regulation.
primary function is to serve as a marketing activity to approach Korean college students aged 19-27 whocontrol
belongto the highest smoking rate group. (The smoking

S14-05South Korea: KT&G Sangsang Univ. Employs CSR for Marketing

rate of Korean young adults aged 20-29 year olds is 53% in men and 11.6% in women.) One of the key
programmes
runSangsang
by KT&G
Univ.theisinstructor
a six orFigure1: During KT&G
Univ.’sSangsang
marketing course,
introduces
uses
KT&G’s
top brand,
Raison, as an
exemplarof a popular andseven week marketing class highlighting KT&G’s tobacco marketing strategies (e.g., building brand image,defiandning
targetgroups,designingproduct
packaging)successful brand. (The real image of the brand is shown in the right hand side.)and its particular tobacco brands as teaching exemplars (Figure 1). Upon completion students receive aformal certificate from KT&G Sangsang Univ., potentially increasing their post-college marketability.
Although the current tobacco-related regulations in Korea restrict advertising of tobacco brands tocigarette retail shops and specific magazines, the marketing class of KT&G Sangsang Univ. enjoys
unregulated use of company brand images.
Previous research found that tobacco industry CSR activities are used to overcome the social
unacceptability of tobacco and smoking, re-build company credibility, improve employee morale, andsecure access to policymakers. In addition to these functions, KT&G Sangsang Univ. has expanded thescope of CSR activities to supporting KT&G marketing, including brand promotion. Because the placeof the marketing course is not a cigarette retail shop and many of the “students” in KT&G Sangsang
Univ. are women, its activities appear as a loophole in Korea’s tobacco control regulation.

S15-01

Recent Findings from the ITC Project on the Effectiveness of Health Warnings in the Asia Pacific Region:

Geoffrey T. FONG
University of Waterloo
Article 11 of the WHO Framework Convention on Tobacco Control (FCTC) and the Article 11 Guidelines adopted at the 3rd Conference of the Parties in 2008
call for FCTC Parties to implement large (at least 50% of the front and back of the package) pictorial health warnings. As FCTC parties begin and continue
to implement these health warnings, there is an accumulation of experiences of these countries, and a growing body of evaluation studies that allow for initialconclusions to be drawn with respect to whether warnings that have been consistent with the Article 11 Guidelines have indeed led to greater effectiveness. This
presentation will summarize findings from the International Tobacco Control Policy Evaluation Project (the ITC Project), with emphasis on recent comparisonsacross the Asia-Pacific and South Asia countries of the ITC Project—Republic of Korea, China, Australia, Thailand, Malaysia, India, and Bangladesh.

S15-02

Advancing Health Warnings Policy with Lessons Learned from Selected ASEAN Countries

Yen Lian TAN
Southeast Asta Tobacco Control Alliance
Globally, countries are acknowledging the harmful effects of tobacco consumption that caused billions of premature deaths and potential life lost to tobaccorelated diseases. The growing rate of smoking prevalence and smoking-attributable mortality is alarming, particularly in most ASEAN countries.
Recognizing that pictorial health warnings (PHWs) is one the most effective tobacco control measure for communicating and increasing awareness amongsmokers and the public of the harmful effects of smoking at no cost to the government, Singapore and Thailand have been lauded for being the first two ASEAN
countries to restrict the use of packs as an advertising medium by requiring PHWs in 2004 and 2005 respectively. This was followed by Brunei in 2008 andMalaysia in 2009.
However, interference by tobacco industry through strong lobbying to policy makers and requesting for longer transition period are common tactics used to delay
the full implementation of PHWs and these remain the greatest challenge for Vietnam and Indonesia. Thailand marked another major tobacco control milestone
with the announcement to implement the world largest PHWs size of 85% which will be enforced in October 2013. This move has received strong opposition
from tobacco industry, particularly Philip Morris International (PMI) which has mobilized lawyers and trade groups to apply pressure on the Thai government.
In Malaysia, tobacco industry, on the other hand, exploited the loopholes in the Control of Tobacco Product (Amendment) Regulations 2008 to dilute the effectsof the pictorial health warning on cigarette packs through various types of packaging design and shapes, colors coding and transparent sleeves with innovative
designs.
Cambodia, Lao PDR and Philippines are trailing behind. The delay in implementing PHWs was attributed to strong tobacco industry interference. For example,
Cambodia failed to meet its obligation to implement PHWs through a Sub-decree on Health Warning in 2009 which was reduced to mandatory textual healthwarnings after strong interference by tobacco industry. The Philippines, is yet another country that is still facing challenges by multiple court cases filed by
tobacco companies to stop the Department of Health (DOH) from enforcing its administrative order requiring nine rotating pictorial health.
It is evident that the tobacco industry interference remains the biggest threat to implementation of strong tobacco control policies in most ASEAN countries,
particularly that of introducing prominent and bigger PHWs.

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1

S15-03

Pathways for the Impact of Cigarette Pack Health Warning Labels on Smokers’ Quitting Behaviour: Findings from the
ITC-4 Country Surveys

Hna-Hie YONG1, Rou BORLAND1, Jim F. THRASHER2,3, Geoffrey T. FONG4,5, K M. CUMMING6, Mary E. THOMPSON4
Cancer Council Victoria1, University of South Carolina2, National Institute of Public Health3, University of Waterloo4, Ontario Institute for Cancer Research5,
Medical University of South Carolina6
Background: Under Article 11 of the WHO’s Framework Convention on Tobacco Control, ratifying countries are obligated to implement health warning labelson tobacco products to help communicate the risks of smoking to both smokers and non-smokers. To ensure its effectiveness, there is a need to understand themechanisms underlying the impact of warning labels—that is, HOW warning labels work. Past research has shown that cognitive reactions such as thinking about
the harms of smoking because of warning labels and behavioural reactions such as forgoing a cigarette because of the pack warnings are key independent predictorsof subsequent quit attempts. However, to date, the mediational pathways for the impact of warning labels on quitting behaviour have not been examined. This
study seeks to address this.
Objectives: To test and develop, using structural equation modelling (SEM), a model of the mediational pathways through which health warning labels exert theirinfluence on smokers’ subsequent quitting behaviour.
Methods: Data come from the International Tobacco Control Four Country Survey, a longitudinal cohort study conducted in Australia, Canada, the UK, and the
US. For the purpose of this study, data collected in Wave 5 (conducted Oct 2006–Feb 2007; n=4988) on warning specific measures (label salience, thoughts about
health risks, forgoing behaviour, label avoidance), general mediators (worry about health damage from smoking, quit intention), and socio-demographic measures
were used as baseline predictors, with quitting data at Wave 6 as outcome.
Results: SEM results indicated that the meditational model tested was a good fit to the data (CFI=.986, RMSEA=.030), accounting for 23.2% of the variance in quit
attempts. Controlling for age, sex, daily cigarette consumption, and country, warning label salience was positively associated with thoughts about risks of smoking
stimulated by the warnings (β=.64, p<.001). Warning stimulated thoughts about smoking risks, in turn, were positively related to increased worry about smoking
doing damage to health and lowering quality of life (β=.59, p<.001); increased worry in turn predicted stronger intention to quit (β=.42, p<.001). As expected,
quitting intention was a strong predictor of subsequent quit attempts (β=.44, p<.001).
Conclusions: Health warning labels have their influence on future quitting attempts primarily through their ability to stimulate thoughts about the risks of smoking,which in turn help to raise smoking-related health concerns, which lead to stronger intentions to quit, a known key predictor of future quit attempts for smokers.

S15-04

Packaging and Labeling of Tobacco Products in Hong Kong

Vienna LAI
Hong Kong Council on Smoking and HealthWorld Health Organization released six MPOWER measures in 2008 which are proven to be the effective ways to combat the global tobacco epidemic. These
measures include “Warn about the dangers of tobacco” and “Enforce bans on tobacco advertising, promotion and sponsorship” which can be achieved throughtightening control on packaging and labeling of tobacco products. Embedding pictorial and written health warning on tobacco packets is the most direct andeffective admonition to smokers and to contend with the intensive promotion of tobacco companies.
Since the enactment of the Smoking (Public Health) Ordinance in 1982 in Hong Kong, the Hong Kong Government has regulated the health warnings on tobacco
products and undergone several phases of changes. They were enhanced from written warnings at the early stage to today’s combination of pictorial and word
contents. The warning has to be positioned on the top of the packet taking up half of the front and back of packet’s surface. Misleading terms such as “low-tar”
and “ultra light” were prohibited.
Although all tobacco advertisements and promotion are banned by law in Hong Kong, tobacco companies still exploit loopholes to promote tobacco products
indirectly, for example using specially designed packaging to attract smokers. Hence, Hong Kong Council on Smoking and Health advocates the Hong Kong
Government to adopt plain packaging as introduced in Australia in December 2012. By standardizing the packaging and expanding the pictorial health warnings,
it is hoped that the misconceptions about relative harmfulness of various cigarette brands can be corrected; up-take of smoking among teenagers and women canbe prevented; the overall appeal of smoking can be reduced and hence further lowering smoking prevalence in Hong Kong to single digit.

S15-05

An Evaluation of the Removal of Tobacco Retail Displays in New Zealand

Gregor WHYTE, Phliip GENDALL, Janet HOEK
University of Otago
Background: In July 2012, New Zealand joined Australia, Ireland and Iceland, among other countries, in requiring retailers to store all tobacco products out ofpublic view. This policy recognises strong evidence that tobacco retail displays increase the risk of smoking experimentation among young people and impede
cessation among smokers who wish to quit. However, despite being in place for more than six months, this policy has not been evaluated. We examined support
for the policy and explored its perceived effects.
Objectives: To examine support for the removal of tobacco products from open display in stores and explore the likely effects of this policy on young people,
quitters and smokers.
Methods: An online survey of 364 smokers (daily and non-daily) and 402 non-smokers (former and never smokers) from throughout New Zealand. Respondents
indicated whether they supported or opposed the new policy and then noted whether they thought the policy would make it harder or easier to achieve specificoutcomes, or whether it would make no difference. These outcomes included effects on own and others’ cessation intentions, ease of quit attempts and maintenanceof smokefree behaviour, and effects on youth initiation and access to tobacco. The order of the response options was reversed for half the sample (to randomise
any item order effects). Analyses were undertaken using SPSS v20.
Results: Overall, 76% of respondents supported the removal of tobacco retail displays. Although most (58%) believed this measure would make no difference
to the ease with which smokers could quit, over two thirds thought the policy would make it easier for quitters to remain smokefree. A similar proportion (63%)
thought the policy would make it less likely that young people would start smoking, and more than half (56%) thought it would make it more difficult for young
people to buy tobacco. Agreement that the policy simplified quitting and protected young people varied by smoking status with daily smokers significantly lesslikely to agree with the benefits relative to occasional, former and never smokers.
Conclusions: Participants supported the removal of tobacco POS displays though saw the policy as preventing youth access and initiation and supporting quittersrather than encouraging cessation.

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S15-06

The Plain Truth: Australia’s World First Plain Packaging Legislation

Kylie. J. LINDORFF
Cancer Council Victoria
On 1 December 2012 all tobacco products for sale in Australia were required by law to be in drab dark brown packaging and be stripped of all colour, branding
and logos. At the same time laws were updated to increase the size and improve the content of Australia’s graphic health warnings. The legislation is consistent
with Australia’s obligations as a party to the WHO Framework Convention on Tobacco Control. The introduction of this world first plain packaging legislation
is a monumental step forward for tobacco control globally with other countries already expressing an interest in introducing similar legislation.
Knowing the global impact a world first like this would have, plain packaging was bitterly opposed by the tobacco industry. A challenge by the tobacco industry
to the legislation in Australia’s High Court delivered an overwhelming 6-1 victory to the Australian Government. Challenges in the WTO and under a bi-lateral
investment treaty are still to be heard.
The intention of the plain packaging legislation is to reduce the appeal of packaging, increase the impact of graphic health warnings and reduce the ability of the
packaging to mislead about the harmful effects of smoking. The positive impact of the legislation was immediate with calls to the Quitline, Australia’s smoking
cessation telephone service, increasing and smokers commenting on the unappealing packaging and believing the taste of tobacco was much worse. These
immediate outcomes are in line with the intention of the legislation.
This presentation will describe: the important steps that lead to the government implementing the legislation and the role of civil society; the tobacco industry’s
challenges to the measure and how the first was overcome; lessons learnt for other countries; and evaluation of the legislation that is available to date.
Relevant topics:
Q – Packaging and labelling
T - Tobacco industry intervention / Corporate Social Responsibility

S16-01

Tobacco Proposal in a 21st Century Free Trade Agreement

Deborah SY
Havison Institute Georgetown University Law Center
Background: The tobacco industry and its affiliates have submitted its position to the negotiators of the Transpacific Partnership Agreement (TPP), a free trade
agreement being negotiated between the US and APEC Countries. It insists on being treated just like any other product and calls for stronger intellectual property
and investor-state dispute settlement provisions (to challenge packaging measures) and removal of broad discretion for health authorities in product regulation.
In the meantime, the US Trade Representative (USTR), in the midst of its WTO case on Clove Cigarettes, has proposed a special provision on tobacco control inthis trade agreement. As a non-FCTC party that aims to make international law provisions comply with its internal law, the US sought only to protect the FDA‘sauthority to implement laws such as the Family Smoking Prevention Act. Another law, the spirit of EO19393 and Doggett Amendment not to promote tobacco
in other countries is not reflected in this proposal. The FCTC to which the US is not a party is not recognized and yet the rest of the countries negotiating the
TPP are FCTC Parties.
At its 15th Round, the United States- Australia, New Zealand, Chile, Peru, Vietnam, Singapore, Malaysia and Brunei - have been negotiating the proposed TPP
agreement since March 2010 . Canada and Mexico have joined the talks during this round.
Method: The author reviewed each provision of the relevant past FTAs and leaked texts to analyze the potential impact of the provisions being negotiated on theimplementation of the FCTC and its guidelines.
Results: Should the tobacco industry continue with its trade litigation strategy, the TPP countries would have provided it with one of its most powerfulammunitions thus far. Many TPP provisions violate basic principles under Article 5.3 and trade the tobacco industry as a partner, and extend benefits to thetobacco industry. Stronger intellectual property rights can be provided to the tobacco industry and it will be very challenging to implement the illicit trade
protocol given the restrictions under the market access chapters.
Conclusions: Various aspects of tobacco control and FCTC implementation must be accounted for in the process of negotiating the TPP. The first step is to treat
tobacco as a unique product that is subject of an international treaty, then to recognize that the FCTC represents a minimum standard. In a special tobacco control
provision in the TPP, TPP participants must aim for coherence between the future of FCTC implementation and the TPP provisions, including the possibility ofcarving out tobacco control measures from the TPP.

S16-02The Globalization of the Tobacco Industry and Implications for Tobacco Control

Frank J. CHALOUPKA
University of Illinois
Over the past few decades, the tobacco industry has become increasingly globalized. This has, in large part, resulted from the proliferation of bilateral, regionaland global agreements that have reduced barriers to trade and investment, the privatization of government run tobacco companies, and mergers and acquisitions
within the tobacco industry. This presentation will highlight the trends in globalization of the tobacco industry and the impact of globalization on tobacco use andits consequences. As the industry has become increasingly globalized, it has used trade and investment agreements to challenge strong domestic tobacco control
policies. Several case studies will be presented, including: the GATT dispute between Thailand and the United States; the WTO dispute between Indonesia andthe United States; Philip Morris Norway's challenge to Norway's ban on the display of tobacco products at the point-of-sale; Philip Morris Asia's challenge toAustralia's plain packing policy; the WTO dispute between several countries and Australia over plain packaging; and others. The implications of rulings in casesthat have been decided and the applicability of the principles that underlie these decisions for ongoing and future challenges will be discussed.

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S16-03

Tobacco Trade in the ASEAN Region: Transit Points and AFTA

Anthony D. SO, Ryan C. DENNISTON
Program on Global Health and Technology Access1, Duke Global Health Institute2
Background
The ASEAN Free Trade Area (AFTA) seeks to foster greater trade among member countries through lower trade barriers. Applied to tobacco, however, lower
barriers risk public health. AFTA places tobacco on the Common Effective Preferential Tariff (CEPT) scheme, where preferential tariffs apply to products thatoriginate within AFTA and are at least 40%, by content, sourced from within ASEAN. If successful, this agreement increases the importance of trade, particularly
with other member states, to domestic public health. To what extent major transit points for tobacco trade have formed within ASEAN has not been wellcharacterized. Do transit points coincide with places where significant trade discrepancies, suggestive of illicit trade of tobacco, exist? Finally, does the contrast
in trade patterns--before and after implementation of AFTA--provide evidence for the impact of the trade agreement on the flow of tobacco?
Methods
To identify potential illicit trade transit points, this study calculates trade discrepancies, differences between imports recorded by a country and exports recordedby its trade partners, to use as a proxy for illicit trade. Trade discrepancies can be analyzed at several levels—bilateral trade, ASEAN-specific trade, and thecollective trade pattern of the ASEAN bloc. To help control for volatility in year-to-year trade patterns and legitimate sources for discrepancies, tobacco iscompared against other leading commodities. We developed maps to detail changes in bilateral trade and discrepancies over time.
Results
Analysis of trade discrepancies reveals several findings. First, cigarettes possess larger discrepancies at the country and bilateral levels than total trade. Second,most ASEAN countries are recipients of illicit cigarettes originating within ASEAN. Finally, as measured by both trade volume and discrepancies, several transit
points shared by several ASEAN members emerge.
Discussion
Article 15 of the Framework Convention on Tobacco Control (FCTC) requires parties to collect data as part of combating illicit trade. This research offers atransparent and replicable method that may identify cases that warrant further scrutiny. Finally, the research highlights the importance of trade issues to future
tobacco control efforts.

S16-04

Does Tobacco Taxation Have an Influence on Industry Consolidation?

Anne-Marie PERUCIC, Nigar NARGIS, Ayda Aysun YUREKLIWorld Health Organization
Recent years have seen increased trade globalization in the form of increased economic integration between countries sharing the same borders. As countries
engage in customs unions and other forms of economic integration, interdependence between countries increases as well. One concern raised by countries thattake part in such agreements is the incentive for tobacco manufacturers to relocate from one country in the economically integrated zone to another seeking fora lower tax burden when there are tax differences between countries. Such concerns have hindered countries from further increasing tobacco taxes. Tobacco
taxation is the most effective and cost-effective measure to reduce tobacco use and its health burden. It is therefore very important to clarify any doubts withregards to the impact of tax differences between countries on industry relocation so that governments are not prevented from improving and increasing their
tobacco taxes on a regular basis.
Based on experience from different countries (particularly in Africa), the presentation seeks to show that the main purpose of the industry’s relocation from one
country to another within the same economic integration zone (or customs union) was not tax avoidance but rather for the consolidation of its production in orderto enjoy larger economies of scale. The examples described will show how the relocations happened and why they were independent from any tax policy. The
presentation will also describe the main benefits of these moves in the context of economic integration zones (or customs unions).
The presentation will then make an analysis of the dynamics of the Asian tobacco market looking at major players (particularly countries from the Association ofSoutheast Asian Nations – ASEAN) and the benefits/losses they would incur from increased trade liberalization. More importantly, the presentation will explore
possible consequences to those countries’ tobacco markets and production as a result of increased consolidation of the industry in the context of ASEAN’s effortsof heightened economic integration.

S16-05The Economic Integration and its Threat to Tobacco Taxation: The Case of ASEAN Economic Community

Sophapan RATANACHENA, Jennie L. REYESSoutheast Asia Tobacco Control Alliance
The ASEAN intends to create an ASEAN Community by 2015 based on three pillars: an ASEAN Political-Security Community, an ASEAN Socio-cultural
Community, and an ASEAN Economic Community (AEC). The AEC shall be the goal of regional economic integration and envisages the following key
characteristics: (a) a single market and production base, (b) a highly competitive economic region, (c) a region of equitable economic development, and (d) aregion fully integrated into the global economy. In short, the AEC will transform ASEAN into a region with free movement of goods, services, investment, skilled
labour, and freer flow of capital.
Undoubtedly, the establishment of AEC will not only lower or eliminate import tariffs of tobacco and tobacco products, it also has the potential to lower domestic
tobacco tax rates, increase accessibility to tobacco products, and provide avenues for illicit trade of tobacco products, all of which will have a negative impact
on public health in ASEAN countries.
The WHO Framework Convention on Tobacco Control (FCTC) recognizes that tax and price measures are an effective and important means to reduce tobacco
consumption among various segments of the population, in particular young persons and the poor, who are sensitive to price changes. In addition, tobacco tax
is proven to be a sustainable source of government revenue for health promotion and social development programs. In ASEAN countries, tobacco tax rates andretail prices are generally low in both absolute and relative terms, while smoking prevalence rates are increasing, largely a result of the failure of tax and pricepolicies to keep pace with the region’s economic growth, inflation rates, and purchasing power of ASEAN populations.
This paper aims to provide a policy analysis on public health and tobacco tax under the regional economic integration through the application of classic free
trade theories of Adam Smith, David Ricardo and Alfred Marshall as well as the New Trade Theories currently used by developed countries to direct trade policy.
Additionally, an impact analysis is presented based on regional researches on Cigarette Affordability and Tobacco Tax Increase Modeling conducted in fivecountries (Cambodia, Indonesia, Lao PDR, Philippines and Vietnam) under the Southeast Asia Initiative on Tobacco Tax of the Southeast Asia Tobacco Control
Alliance.
In order to facilitate effective implementation of the FCTC and to protect public health throughout the region, this paper recommends that in establishing the
AEC, tobacco should be excluded from all trade and cooperation agreements among ASEAN member states because it is a uniquely harmful product, and tobacco
tax and price policies should be safeguarded in the promotion of free trade in the region. Ultimately, it aims to raise awareness among policymakers in ASEAN
to prioritize public health in the trade cooperation of AEC.

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S17-01

How Does Big Tobacco Love Government Interference?
Let Us Count the Ways

Mark LEVIN
Univesity of Hawaii
Without a doubt, Article 5.3 is the beating heart of the FCTC. Its vitality is the central element for the success or failure of the vision expressed in Article 3,enthusiastically adopted by FCTC member states.
The rationale for my bold statement here should be obvious. When governments and their agents are able to operate free from tobacco industry interference, mostwill choose to adopt the life-saving and socially beneficial policies incorporated in the remaining provisions of the Treaty. Thus, tobacco industry interference
represents the single greatest impediment to our progress. Our mission demands in return that we employ Art. 5.3 to its fullest advantage.
As the first presenter in our panel session looking at tobacco industry interference, I will quickly introduce Art. 5.3 and its implementing guidelines. I will thenlaunch a brief participatory workshop aiming to inventory ways that audience members have witnessed Big Tobacco infiltrating political society in their local
surroundings.
Let's not let ourselves be fooled. Big Tobacco devastatingly insinuates itself into public policy choices in every way that it possibly can. We must take note of
the obvious and hidden routes, and make ourselves ready to block them wherever we can.

S17-02

What Hinders Implementation of the WHO FCTC Article 5.3 in South Korea ?

Sungkyu LEE
Center for Tobacco Control Research and Education, University of California
Keywords: Tobacco, Tobacco control, Tobacco industry, FCTC, Article 5.3
Since 1988, the South Korean government and tobacco control advocates made efforts to reduce smoking prevalence in Korea. In turn, the male smoking
prevalence decreased from 79% in 1980 to 40% in 2006. However, from 2006 the decline reversed to an upward trend, returning to 48% in 2011. The WHO
Framework Convention on Tobacco Control (FCTC) Article 5.3 states that ratifying nations should be alert to any efforts by the tobacco industry to undermineor subvert tobacco control efforts. Although controlling tobacco industry based on the Article 5.3 is essential, there have been no efforts in Korea to implement
Article 5.3. The study determined whether the Korean Ministry of Health (MOH) properly understood Article 5.3 and how the tobacco industry interfered in
tobacco control policies.
Government official documents and reports on tobacco control were collected and reviewed. We also searched and analyzed tobacco industry internal documents
available from the Legacy Tobacco Documents Library. Initially, the search term, ‘Korea’ was used and to narrow down the sample of documents, the study
combined search terms “Ministry of Health” and “tobacco control policy” to identify how the industry attempted to interfere in tobacco control policies in Korea.
There were three factors that hindered the implementation of Article 5.3 in Korea. Firstly, due to a direct conflict between two tobacco-related laws: one designed
to promote the tobacco industry and the other designed to promote public health. Tobacco industry interference [in public policy making] has not been an issueof concern in tobacco control policy making. Secondly, the government has not fully understood Article 5.3. The government overlooked the tobacco industry’s
corporate social responsibility (CSR) activities which reduced the effectiveness of tobacco control policies, and gave a prize on two occasions to honor Philip
Morris Korea’s CSR activities which include helping the poor. Additionally, the MOH has increased its investment in the tobacco industry since 2009 using the
National Pension Fund. Thirdly, when new tobacco control regulations were introduced, the tobacco industry actively put forward their opinion to the MOH andthe MOH recognized tobacco industry as an important stakeholder on tobacco control policy, which is against the FCTC’s recommendation.
The Korean government has largely overlooked the tobacco industry practices that undermine the existing tobacco control policies and attempt to block newpolicies. The government needs to fully understand Article 5.3 and immediately stop their support for tobacco industry’s CSR activities and investment in the
tobacco industry using the National Pension Fund.

S17-03

Non-Compliance with FCTC Article 5.3 and Article 19 in Japan

Koki OKAMOTO
Lawyer
Article 5.3 to protect public health policies from the tobacco industry
JAPAN TOBACCO INC. (JT) has very strong power in Japan economically and politically. The Japan’s Minister of Finance still owns 33.35% of the sharesof JT. The Tobacco Business Law is incompatible with FCTC. The declared purpose of the law is “to promote the sound development of the Japanese tobacco
industry, thereby securing national revenues.” The provision should be abolished, but the Diet is unlikely to amend the law. There are a lot of violation and noncompliant situation against Article 5.3 in Japan. The Ministry of Finance (MOF) hardly monitors JT from the perspective of FCTC, and to make matters worse
MOF publicly seems to allow JT’s “freedom of speech”. MOF and JT mutually exchange their personnel. The retired officers from MOF get high-class job into
JT and earn expensive pay. Actually, some of the Diet members influenced by JT have harshly opposed and collapse policy of the Ministry of Health (MOH). For
example, MOH several times failed to set a target for reduction percentage of the smoking prevalence. Around 2007 JT harshly opposed the start-up of the local
ordinance of Kanagawa prefecture which aims to protect people from second-hand smoke indoor and to restrict indoor smoking at public places, restaurants,
hotels and so on for the first time in Japan. 2009 the first indoor protection ordinance was passed after a great struggle, but after all it had been weakened by
oppositionist. JT always opposes tax raise of cigarettes for fear of a decrease in the consumption. MOF every year invites JT and other foreign tobacco industries
and ask for their opinion about tax. We, our NGO and anti-tobacco lawyers including me, have criticized each JT activity and MOF failure to monitor JT above,
but they have ignored. We NGO have to keep criticizing and monitoring in accordance with FCTC 5.3. Article 19 Liability Anti-tobacco lawyers have sued JT
several times. However we couldn’t win any cases in Japanese courts. The plaintiffs were ex-smokers, that is to say victims of tobacco related diseases, ex.
lung cancer, COPD, etc. Now another case is under procedure, the plaintiff of which is non-smoker who had suffered from passive smoking for 25 years. He
got a larynx cancer and heart disease. I hope a good judgement for justice. While the cases against JT or MOF all failed, some of the cases against employers ofworkplace with second-hand smoke resulted in winning lawsuit. Still winning is not so easy. It needs a lot of judicial evidence and great effort in the proceedings.
However lawsuit against employers related to passive smoking is certainly making progress. My opinion is that JT should be more liable as very big industry
than civil employers. We have to make the first step of “Liability” of JT.

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S17-04

New Zealand Smokers’ and Non-Smokers’ Support for End-Game Retail Policies

Philip GENDALL, Gregor WHYTE, Janet HOEK
University of Otago
Background: In 2011, the New Zealand government announced the goal of becoming a smokefree nation by 2025. This means reducing the current smoking
prevalence of seventeen percent to less than five percent. Tax increases, graphic health warnings and bans on smoking in public places have been introduced,
and plain packaging of tobacco products is being considered. However, apart from a policy implemented in 2012 that required removal of tobacco retaildisplays, supply-side initiatives have received less attention from policy makers. Thus we examined support for retail interventions that would further reduce theavailability and accessibility of tobacco products in New Zealand.
Objective: To inform “end-game” intervention strategies by estimating smokers’ and non-smokers’ support for policies that would further regulate tobacco
retailing.
Methods: An online survey of 364 smokers and 402 non-smokers from throughout New Zealand. Respondents used an 11-point scale (anchored by -5, strongly
oppose and +5, strongly support) to indicate their support for or opposition to five potential retail policies: reductions in the number of retail outlets; not allowing
tobacco sales in outlets that sold alcohol or that were within 500 metres of a school; retailer licensing, requiring cessation products to be sold wherever tobacco
was sold and phasing out sales of tobacco in New Zealand by 2025.
The response scales for each policy were collapsed into dichotomous oppose/support variables and used as the dependent variables in logistic regression
analyses, with smoking status, age, gender and ethnicity as the independent variables.
Results: There was overall support for each of the potential policies, but this was consistently and significantly associated with respondents’ smoking status.
Responses to all initiatives showed a consistent trend of increasing support from daily smokers to occasional smokers to former smokers to non-smokers.
Daily smokers strongly opposed reducing the number of tobacco outlets, not allowing tobacco sales in outlets that sold alcohol, and phasing out tobacco sales
altogether; they also opposed licensing of stores selling tobacco. Social smokers opposed the phasing out of tobacco sales. However, all groups supported notallowing tobacco sales within 500 metres of a school and requiring cessation products to be sold wherever tobacco was sold.
Conclusions: The two policies with the strongest support appear the most likely to deter youth initiation and promote cessation among existing smokers andprovide clear guidance to policy makers looking to strengthen supply-side measures.

S17-05

Tobacco Industry’s Tactics to Challenge Effective Tobacco Control Activities from a View Point of Product Innovation

Yumiko MOCHIZUKI-KOBAYASHINational Cancer Center
Tobacco control in Japan has gradual achievements in terms of smoking prevalence, consumption and social norm due to timeless efforts to curb the tobacco
epidemic at all levers. Recent policy progresses in Japan are as follows; first-ever achieved numerical goals to reduce tobacco use by the government, policy
frames such as Health Japan 21 and Cancer Control Plan, local initiatives to enact smoke free ordinances and health insurance coverage for smoking cessation.
However, tobacco industry is sneaking to deterJapan Tobacco Inc. (JT) is the world third multinational tobacco company originated from a domestic state monopoly in Japan. It’s partial privatization in mid80’s and acquisition of foreign tobacco companies since late 90’s strengthened its power to survive under global tobacco control era, financially, politically,
and technically. Here, I will discuss the most recent potential risk to tobacco control from a viewpoint of product innovation among other industry’s tactics tointervene the policy and the society.
Tobacco industry has been facing serious challenges under Framework Convention on Tobacco Control (FCTC). Many countries have achieved tobacco control
efforts at a required policy level by FCTC and could successfully deter tobacco epidemic among the current generation and possibly among the next generation.
In those countries, social norm has changed that smoking is no more acceptable in public but on contrary so-called “smokeless” tobacco challenged thesechanges. Japan is not an exception although the current smokeless consumption is relatively negligible. The previous efforts by foreign tobacco industry such as
American Snus in mid-80’s and Swedish gum tobacco in early 2000’s were both failed due to concerted actions by the Ministry of Health and tobacco control
advocates against their marketing.
Recently, JT launched an innovative type of smokeless tobacco, Zero Style in 2010 when smoke-free ordinance was enacted in Kanagawa Prefecture and it
expands its product profile to more attractive form, namely “Snus” under the same brand name. Disclaimers such as Light and Mild could not be used under
FCTC but JT will continue to use them in Japan. In addition, FCTC does not prohibit to use “zero” as a part of brand name despite it certainly misleads theconsumers that the product might be zero risks. An optimistic scenario is that cultural preference would reject oral use of tobacco and that snus market would be
failed. However, we should be more prepared for a more pessimistic scenario that snus would attracts both youth and smokers as other countries are experiencing.

S17-06

Legal Implications of WHO/FCTC Declarations on Tobacco Disputes under WTO and BITs: How Could They Help
Parties Fighting against Tobacco Industry?

Pei-Kan YANG
National Chengchi University
Tobacco companies have made all possible legal approaches to challenge governmental regulations on tobacco products such as ban on tobacco advertising, plain
packaging or health warning requirements. In addition to the constitutional claims filed at domestic courts, they frequently relied on the international trade andinvestment laws as the legal foundation for their claims against tobacco control measures. Several ongoing trade and investment disputes under the World Trade
Organization (WTO), e.g. Australia—Tobacco Plain Packaging and International Centre for Settlement of Investment Disputes (ICSID), e.g. Phillip Morris v.
Uruguay are vivid examples of such attempt made by the tobacco industry. These disputes have worried many health experts that the public health policies may
be sacrificed for commercial investment or trade interests. In response, the Parties to the Framework Convention on Tobacco Control (FCTC) under the World
Health Organization (WHO) have jointly adopted several Declarations, such as the Punta Del Este Declaration in COP4 and Seoul Declaration in COP5, with the
purpose of assisting Parties in fighting against tobacco industry by reaffirming the commitment to the protection of public health.
This paper tries to evaluate the legal implications of these joint Declarations on the adjudication of current trade and investment disputes and argue the possible
ways for helping Parties defending the case based on these Declarations. Several legal issues are worth exploring. For example, what legal value of these
Declarations may be ascertained by the panel or arbitrators in adjudicating the disputes? What role of these Declarations may be played during the adjudicatory
proceeding, either as an interpretative tool or an affirmative defense? This paper tries to argue that these Declarations should play a more active role as anaffirmative defense available for respondent States instead of simply having the evidentiary value for treaty interpretation. This paper also examines the possible
criteria for determining the applicability of these Declarations as available affirmative defenses in defending the case. The ultimate purpose of this paper is try tofind ways to help Parties protecting their public health policies from legal challenges of the tobacco industry under the international trade and investment regime.
Keywords: Punta Del Este Declaration, Seoul Declaration, WHO/FCFC, WTO, ICSID, Phillip Morris v. Uruguay, Australia—Tobacco Plain Packaging,International Investment Dispute, Applicable Substantive Law, Customary International Law

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S18-01

Inequities in Tobacco Use and Tobacco Control and its Implication for Tobacco Control

Hong-Jun CHO
University of Ulsan College of Medicine
Tobacco was the most important preventable cause of mortality and morbidity. Tobacco use has been more prevalent among lower socioeconomic groups inWestern countries, however this trend occurs also in East Asian countries including South Korea, Japan, Taiwan and China. In some countries (e.g., South
Korea) socioeconomic disparities in smoking prevalence have been widened relatively and absolutely among both genders. Because socioeconomic disparities
in smoking rate were the main contributor to inequalities in smoking-related morbidity and mortality, they should be reduced as soon as possible. Socioeconomic
disparities in smoking rate are originated from socioeconomic differentials of initiation and/or quitting of tobacco use. Smoking disparities depend on the
differential effect of specific tobacco control policy on different socioeconomic groups. Some tobacco control policies including banning marketing, rising
tobacco prices, workplace interventions, free supply of cessation aids, and telephone help lines were considered to be potentially effective to reduce tobacco
disparities (Kunst A, et al, 2004). Tobacco tax increases tended to be more effective among lower income group and lower income countries than higher income
groups and countries, however the effect on lower education group and occupation was not evident. National smoking cessation program in UK focusing service
on more deprived area showed the potential of reducing smoking disparities, however the size of disparities reducing effect were marginal. National smoking
cessation service in Korea, which did not focus on the poor, did not reduce smoking disparities, moreover tended to widen it. Effect of many tobacco control
policies including mass media campaign, labeling of cigarette package, ban on tobacco marketing and smoke-free policy on the poor were not studied well.
Many tobacco control policies did not show to reduce smoking disparities till now, even when they targeted lower socioeconomic groups. Because reducing
socioeconomic disparities in smoking rate is one of the urgent public health issues, we need to study and implement tobacco control policies which are accessible
geographically, financially, and culturally for lower socioeconomic groups.

S18-02

A Health Inequities Challenge for Tobacco Control in Indonesia: Who Smoke More in the Last Decade?

Yayi S PRABANDARI
Universitas Gadjah Mada
Background: As the only country in the Asia Pacific that has not ratified FCTC, Indonesia has minimal tobacco control policy. A new tobacco regulation justapproved by the Indonesian president in December 2012, but the execution will be done in 18 months afterward. In accordance with the limited tobacco control
interventions and policies, the prevalence of smoker in Indonesia remains steady for the last ten years. This situation is alarming since Indonesia will implementa national insurance in 2014.
Objective: to study the health inequities among smoker across gender, educational and socio-economic background
Method: This paper used the Indonesian National house hold health report 2001 and 2004, Basic health research 2007 and 2010 to study the health inequities
descriptively.
Results: Smoker was found more on male, poor and low educated people in the 2001 and 2004 National house hold health survey. Moreover, people who have
not had health insurance were found more among smoker. This pattern slightly similar compared to the basic health research 2007 and 2009. Smoker was foundmore among man, less educated and poor people. Those who smoked were found more in rural area. Although woman less smoked than man, the prevalence offemale smoker has increased in 2007 and 2010 basic health survey compared to the national house hold health survey 2001 and 2004.
Conclusion: This study reveals that there was an inequities access of health insurance among smoker in the 2001-2004 national house hold health survey. Healthinequities also found more on smoker across gender, educational and economic background in both types of surveys. Wide and comprehensive tobacco control
intervention was needed.
Keywords: health inequities, tobacco use, tobacco control

S18-03

Cigarette Consumption and Quitting Behaviour among Smokers in China: Finding from ITC China Survey

Jilan YANG , David HAMMOND1, Susan HORTON1, Geoffery FONG1,2, Yuan JIANG3
University of Waterloo1, Ontario Institute for Cancer Research2, Chinese Center for Disease Control and Prevention3
1

Background: Associations between cigarette consumption level and smoking cessation-related behaviour, including intention to quit, receiving doctor advice,and stop smoking medication use have been well documented in western countries. However, as the country home to one third of worldwide smokers with 52%
of smoking prevalence among which more than half are heavy smokers (cigarette per day ≥20), China has limited research evidence on association of cigarette
consumption level with quitting behaviour.
Objectives: This study examined the extent to which daily cigarette consumption among smokers (light, medium and heavy smokers) were associated to quitting
and receiving doctors’ advice, and smoking cessation medication use.
Methods: The ITC China survey is a prospective cohort face to face study conducted in six selected cities in China. Smokers in Wave 2 were asked their average
daily cigarette consumption, whether they had plans to quit smoking, if they received quitting advice during their doctor visit during the past 12 months, and ifthey used smoking cessation aid. Smokers in Wave 2 who were re-contacted in Wave 3 were asked if they had quit. Longitudinal analyses were conducted using
Wave 2 (November 2007 to January 2008) and Wave 3 (May to October 2009).
Findings: in China, the annual quit rates among light smokers (daily cigarette consumption ≤10), medium (11< daily cigarette consumption<19) and heavy
smokers (daily cigarette consumption ≥20) were 10.2%, 4.7% and 3.68%, respectively. Light smokers in China were significantly more likely intend to quit
smoking (medium vs. light: p <0.001; heavy vs. light: p=0.001) and successfully quit smoking (medium vs. light: p <0.001; heavy vs. light: p=0.0012), butthere was no significant difference on quit intention (p=0.0541) as well as successfully quitting (p=0.6158) between medium and heavy smokers. Significantly
more light smokers in China reported received doctor’s quitting advice (20.7%), relative to medium smokers (17.5%) and heavy smokers (12.5%). There wasapproximately 3% smokers reporting use medication during quitting, however, there was no significant difference on smoking medication use in heavy, medium
and light smokers (heavy vs. medium p=0.8395; medium vs. light p=0.7076; heavy vs. light p=0.9175).
Conclusions: Light smokers in China are significantly different than medium and heavy smokers in quitting smoking, while there is not much difference on
quitting between medium and heavy smokers. The evidence is important for planning effective smoking cessation intervention at population level.

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Incorporating National Tobacco Control Laws into Existing Sub-national Governance Mechanisms: A New Approach to
FCTC Implementation in India

Vandana SHAH1, Tarkeshwar Prasad SINGH2, Sanjay SETH1, Arvind SINGH2, Hema KHANCHANDANI1Campaign for Tobacco Free Kids1, Cancer Awareness Society - Bihar, India2
Background: The Indian Cigarettes and Other Tobacco Products Act (COTPA) was enacted in 2003, but as is the case in many middle/low- income countries
passage of tobacco control laws doesn’t necessarily translate into effective implementation or enforcement. To first prioritize tobacco control implementation,
sub-national NGO’s sensitized key decision makers so that appropriate local orders were passed to activate COTPA implementation and to create oversight fromabove. Secondly, the local advocates devised a sub-national strategy where different departments of the state governments (i.e., health, education and police)
were trained on incorporating COTPA implementation within the scope of their existing duties. These agencies were then held accountable for reporting COTPA
violations within their existing monthly reporting systems. This model is being tested out in five focus states across India.
Objectives and methods: 1) Briefly describe COTPA provisions that need to be implemented by the sub-nationals; 2) Explain the rationale for activating
education and police sectors in addition to health; 3) Describe the reporting model and implementation steps taken; 4) Highlight key stakeholders; 5) Identify
challenges and successes; 6) Updates (one year later) and way forward.
Results: The first phase of this newly devised system has been deployed during 2012. As of December 2012, four focus states have activated their police andeducation reporting mechanisms. Initial reports show significant rates of compliance in the education sector reports. Since allocation of national and sub-national
resources for tobacco control implementation remain low, such incorporation into existing governance systems will be critical for long-term sustainability.
Conclusions: Though tobacco control is a health issue, it is important to engage multiple government agencies to make enforcement effective and sustainable.
While the health sector has a very central role in informing about the harms of tobacco use, the reality is that as a government agency, it has limitations in
implementing and enforcing tobacco control laws. Thus the roles of police etc are important in building an effective enforcement system.

S18-05

Play the Role of Non-governmental Organisations, Fight against Tobacco Industry Interference with Tobacco Control

Guihua XU
Chinese Association on Tabacco Control
In 2005, China's National People's Congress Standing Committee approved “World Health Organization Framework Convention on Tobacco Control (WHO
FCTC)” which came into effect on January 9, 2006 in China. Since then, China has officially began its comprehensive tobacco control performance. In the past
6 years, tobacco control has been struggling to move forward along with the continuous deepening of the performance. China Tobacco Control Association, as
China's tobacco control NGO, has been following the Convention over a long period of time, and sticks to MPOWER strategy, mercilessly exposing and resisting
tobacco company funding for schools and charity, sponsorship of cultural and sports events and activities and other donation from tobacco companies; tobacco
products promotional behaviour; disguised tobacco advertising in films and television dramas; cigarette packaging, and the "low tar" development of the tobacco
industry, etc., constantly promotes tobacco control efforts from the perspective of the civil society in China and carries out efforts to build a comprehensive
smoke-free society.

S19-01
Nicole M. SUTTON
REAL: Hawaii Youth Movement Exposing the Tobacco Industry, University of Hawaii
AREAS OF EXPERTISE
Monitoring of tobacco industry activities
Youth empowerment & advocacy
Youth tobacco prevention & social marketing
LGBTQI tobacco control issues
Development of counter-marketing initiatives
Community mobilization
Developing youth adult partnerships
Guerrilla activism
EDUCATION
Bachelor of Arts, 1999
Major: Sociology
The University of Tampa
Minor: Women’s Studies
Tampa, Florida
EMPLOYMENT
Project Director
2003 - Current
Assistant Coordinator
2002 - 2003
Research Associate2000 - 2002
REAL: Hawaii Youth Movement Exposing the Tobacco Industry
School of Nursing and Dental Hygiene
University of Hawaii
Honolulu, Hawaii• Oversee all aspects of a youth-led, tobacco control advocacy campaign with more than 6,000 youth members• Closely mentor annual statewide team of 20 youth leaders (have mentored a total of 263 young leaders for tobacco control)• Facilitate youth planning process for campaigns and community mobilization• Recruit, train and manage 6 regional adult coordinators and 5 support staff• Coordinate youth action for all events, media outreach, trainings, and legislative hearings• Prepare funding proposals and reports• Maintain community partnerships and collaborations• Serve on various committees and workgroups for tobacco control at local, state, national, and global levels• Present at 3 – 4 conferences and workshops each year
• Assist in building project evaluation• Provide technical assistance and training to other groups at local, state, national and international levels
PUBLICATIONS
Sutton NM, Suzuki TM, Della D., Albright C., O’Riordan DL. Involving Hawaii’s youth as partners in global health initiatives to impact change at the local level. Hawaii Medical Journal, Vol 66, Sept 2007
Glanz K., Sutton NM, Jacob Arriola, KR. Operation Storefront, Hawaii: tobacco advertising and promotion in Hawaii stores. Journal of Health Communication, 11:699-707, 2006
O’Riordan DL, Sutton NM, Haro-Arvizu P. A community-based approach to tobacco prevention: Hawaii’s youth taking on the tobacco industry. Hawaii Medical Journal, Vol 64, Nov 2005

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S19-02

Adolescent Awareness of a Tobacco Promotion in Malaysia and Thailand: Findings from the ITC SEA Project

Maizurah OMAR1, Rahmat AWANG1, Noor A. A. RANI1, Haslina HASHIM1, Halilol R. KHAN1, Sulastri SAMSUDIN1, Buppha SIRIRASSAMEE2,
Anne C. K. QUAH3, Geoffrey T. FONG3,4, Ron BORLAND5
Universiti Sains Malaysia1, Mahidol University2, University of Waterloo3, Ontario Institute for Cancer Research4, The Cancer Council Victoria5
INTRODUCTION: Malaysia and Thailand ratified the WHO Framework Convention on Tobacco Control (FCTC) in September 2005 and November 2004
respectively. At present, Malaysia has not fully compliance with Article 13 as cigarette packs are displayed and promoting tobacco products inside stores at pointof - sales . Thailand, has implemented comprehensive ban on tobacco advertising, promotion, and sponsorship.
METHODOLOGY: Data were collected in four consecutive waves from 2005 to 2009 as part of a longitudinal cohort study using stratified multistage-cluster
sampling design. A total 1011 and 1000 of adolescents in Malaysia and Thailand were recruited (Wave 1) from January to March 2005, a total of 807 and 967
of adolescents respectively in Wave 2 (March to Sept 2008), 762 and 1096 respectively in Wave 3 (March to Sept 2008), and finally, a total of 881 and 956 ofadolescents respectively were recruited respectively in Wave 4 (July to Dec 2009)..
RESULT: Overall, more than 33.2% (Malaysia) and 48.3% (Thailand) of adolescents in baseline (2004) were reported to have noticed things that are designed toencourage smoking or think about smoking. The media channels mostly noticed were posters (72.1%), television (68.4%), billboards (61.0%), in shops (60.2%),
and newspapers (55.1%) while in Thailand,were mostly in shops (28.9%), in disco/karaoke lounges (18.5%), around street vendor (17.0%), and television(12.0%). The percentages in Thailand were lower than Malaysia. However, noticing of tobacco advertisement in both countries showed a declining trend witha significant drop in 2008. Noticing cigarette packs displayed inside stores at point-of-sales by adolescents in both countries showed an increasing trend from
72% in 2007 to 83% in 2009 and from 47% in 2007 to 50% in 2009 respectively. More than 70% of adolescents in Malaysia and Thailand were reported to havenoticed actors smoking either on television, videos, or movies throughout the four waves and the trend is increasing each year.
CONCLUSION: Tobacco advertisement and promotion continue to be present and noticed by adolescents in both Malaysia and Thailand especially throughpoint-of-sales in Malaysia and electronic media.
ACKNOWLEDGMENT
The ITC-SEA Project is supported by grants P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center), R01 CA100362 from the National
Cancer Institute of the United States, Canadian Institutes of Health Research (79551), Ontario Institute for Cancer Research, ThaiHealth Promotion Foundation,and the Malaysian Ministry of Health. We would also like to acknowledge the other members of the ITC Project team.

S19-03Engaging Children for Tobacco – Free Schools

Tshering D. BHUTIA, Narayan LAD, Devika CHADHA
Salaam Bombay Foundation
Background and Objectives: The Indian government, in 2003 passed the “Cigarettes and Other Tobacco Products Act” (COTPA), Section 6 of which prohibitssale of tobacco products to children below 18 years of age and for any tobacco shop to be located within 100 yards of any educational institution. However, shops
selling tobacco are found at every nook and corner thereby exposing children to attractive and affordable tobacco products, increasing the likelihood of children
purchasing and using tobacco. Salaam Bombay Foundation (SBF) with help of trained children conducted an observation to assess and address enforcement andviolation of section 6 of COTPA.
Methods: Children from 58 schools made list of 63 tobacco shops around their school premises, and discussed the issue within their “Children Health Assembly”(group of selected leaders from each school), where they made a demand charter for Municipal Education Committee Chairman. The results of the observation
were shared with key members of Municipal Corporation of Greater Mumbai (MCGM) - Commissioner, Superintendent of Shops and Establishments, andHealth Executive Officer. Subsequently, SBF conducted follow-ups with appropriate government authorities to advocate for the effective enforcement of the law.
Results: Children’s observations revealed presence of tobacco vendors within 100 yards of 82% of observed schools, and not displaying any health warning
boards. Children explained existing law to vendors and asked them to stop selling tobacco to children below 18 years of age and wrote letter to officials at Foodand Drug Administration. Official letters were sent to municipal wards and educational institutions for enforcement of Section 6. As a result of SBF’s advocacy
to incorporate Section 6 of COTPA in “Shops and Establishment” license, MCGM in April 2012, made compliance of Section 6 a part of licensing conditions of
all licensed trades, including pan shops. If traders / shops were found violating provisions of the Section, stringent action would be taken - giving warning letter
followed by revoking license. Post Section 6 incorporation in “Shops and Establishment” license, fresh list of vendors within 100 yards of schools was submitted
to 24 wards, leading to action on 540 illegal and 51 legal shops violating law. License Department assured continuance of further action.
Conclusion: Despite government rules, vendors openly sold tobacco products within 100 yards of educational institutions. However, SBF’s innovative advocacy
engaging children yielded fruitful results.

S19-04

Qualitative Analysis of Factors Affecting the Difficulty Quit Smoking of Students State Islamic University Jakarta

Ahmad R. NUBAIRI, Mochamad I. NURMANSYAH, Badra AL- AUFA, Erna WATI, Waras BUDI UTOMO
Syarif Hidayatullah Islamic State University of Jakarta
Day by day, the total of smokers has increased in many countries in the world, either in the developed country or in the developing countries. In 2008, the numberof smoker Indonesia takes on third place in the world after China and India. Some disease caused by smoking as hypertension, stroke and cancer; however it
doesn’t make smokers to stop smoking. In reality, several times the smokers try to stop smoking but they often failed. The purpose of the research is to find out thefactors that influence the difficulty for State Islamic University Syarif Hidayatullah Jakarta students to stop smoking. This research is qualitative descriptive withphenomenology approach. The type of the data is the primary data. The collecting data is conducted by depth interview with 12 informants. The data analyzing
is descriptive-narrative. The data reported that smokers start smoking since elementary school, junior and senior high school. The result of the research show that
personal factor, addiction factor, social influenced factor, peers factor, easy access getting cigarette factor, and the role models of smokers factor influence UIN
Jakarta student to stop smoking.Motivation to stop smoking backed up by self intention, social environment without smokers, health and economy factor. Effort
to stop smoking can be conducted by reducing portion smoking, avoiding smokers environment, exercising, and shifting smoking desire with other activities.
Obstacle factor to stop smoking come from personal intention, smoking addict, social environment influence, easy access getting cigarette, and the role models of
smokers. Recommended suggestion is necessary for establishing both education and health promotion about dangerous smoking. In addition, making regulation
for no smoking area.
Key Word: difficult to stop, smoking behavior, student

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S19-05

United for Tobacco Free World. “What should WE do?”Apact YOUTH
On 18th August, as APACT pre-program, there was the first APACT youth conference aiming to share fresh ideas and perspectives on tobacco control among young generation in Asia-pacific region
and to engage, inspire and empower youth in tobacco control. This youth conference was formed in response to growing recognition of the critical role that youth plays in tobacco control, both as atarget group and as partner. Youth conference was launched this year for the first time with a mission to bring fresh ideas from several countries in Asia and Pacific to forefront and increase awarenessto tobacco control among young generation. The youth conference constitutes a source of knowledge and innovation, and provides participants an excellent resources and opportunities to make avital contribution to the youth specific agenda in tobacco control and other important tobacco issues.
This youth conference provides knowledge and skills to participants intended to1. Raise awareness for tobacco epidemics especially among young generations and create global young leaders in next generations.
2. Create Asia – pacific networks among young generations in order to address tobacco issues.
Programs are as follows;• Key Note lecture 1“Youth and tobacco advertising, promotion and sponsorship”
Dr. Douglas W. Bettcher
Director, Prevention of Non-communicable Diseases (PND), World Health Organization• Key Note lecture 2“What is done and what is to be done”
Dr. Yumiko Mochizuki
Division Chief, Tobacco Policy research Division, Center for Cancer Control• Luncheon Session(TBA)
Dr. Akinori Kuruma• Poster presentation
Share good practices related to tobacco control among countries.
• World Café
Divided into small groups and discuss challenges and countermeasures for tobacco epidemics.
• Keynote remarks“Youth Activism: Empowering the Next Generation of Tobacco Control Partners!”
Nicole Sutton
At this session, delegates of this youth conference will present what they discussed and outcomes of this youth conference.

Luncheon Seminar 1
Elif DAGLI
Health Institute, Turkey
Scientific Chair Turkish Thoracic Society
Tobacco use has killed more than armed conflicts, genocides, natural disasters, infectious disease epidemics, traffic accidents.
If we can not be very effective in controlling the use of this man-made lethal,yet still legal product, there will be one billion
deaths in this century. Inspite of the fact that recipe for effective tobacco control is simple and do-able, not many governments
has taken full action.
Turkey, a tobacco producing country with long-standing tobacco monopoly, became a successful tobacco control leader. In
1988 smoking rates were 63% among males and 24% among females. After market liberalization the tobacco consumption
had increased by 50% in 10 years. Between 1964 and 2004 lung cancer hospital increased 40 fold. Tobacco was doing more
harm than good to Turkish economy and public health. It was time for action. Following Turkey’s formal adoption of WHO
Framework Convention on Tobacco or Health (FCTC) in 2004, the country made great progress in legislating and implementing
comprehensive Smoke-free, health warnings, taxation, advertising ban policies, and became a role model for a large number of countries.
FCTC and MPOWER strategies were the guidelines for action:
Monitorization of tobacco use was carried out by Global Adult Tobacco Survey regularly.
Protecting people from tobacco smoke was achieved by smoke-free legislation
Offering help was performed by integrating smoking cessation into primary care services and training physicians.
Warning about the health hazards was realized through pictorial warnings that covered 65 % of the cigarette packs as well as anti-tobacco tv spots .
Enhancing advertising bans that were already part of legislation since 1996 , was possible by expansion to point of sales and promotion and sponsorship issues.
Raising taxes on cigarettes up to 82% was reached by gradual increase in a few years
As a result of tobacco consumption went down by 12 %, and emergency hospital admissions of tobacco- related diseases by 20% between 2009 and 2010 andtax revenues increased.
This was made possible by rapid and bold steps taken by the Government, and financial and technical support received by the tobacco control coalition of civilsociety.

Luncheon Seminar 1

Issues Concerning Anti-Smoking Programs in Japan

Yoko KOMIYAMA
Former Minister of Health, Labour and Welfare
The Yoko Komiyama Policy Research Council
In 2002, I launched the bipartisan Anti-Tobacco Promotion League to advance, Anti-Tobacco Promotion in Japan. In the same
year, the Health Promotion Act, which helped to expand a ban on smoking in public places, was enacted in Japan. The WHO
Framework Convention on Tobacco Control (FCTC) was adopted in May 2003, and alongside members of the League, I worked
to ratify it in Japan the following year.
The vested interests that promote smoking, tobacco farmers, tobacco companies, and retail stores, have great influence in Japanesepolitics, as evidenced by the fall in League membership as elections approach. As a consequence, anti-smoking measures will
not make headway unless scholars, researchers, and NGOs who wish to promote such measures, exert a greater force in politics.
After the Democratic Party of Japan took power, a raft of new anti-tobacco measures were introduced. Previously, the price of tobacco in Japan had been about
half that of other industrialized nations. For the first time, the government raised the tax on tobacco by 5 yen per cigarette, although this, unfortunately, was as
far as we got. As Minister of Health, Labour and Welfare, I incorporated, for the first time, various numerical targets for smoking cessation in the Cancer Control
Act and in Health Japan 21, which is a ten-year campaign to promote healthy behaviours.
Unfortunately, during my tenure, I was unable to pass bills that would have revised the Industrial Safety and Health Law to cover secondhand smoke inworkplaces. I believe that it is crucial to make the dangers and ill effects of secondhand smoking more widely known. This is an issue that must be addressedin Japan.

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Luncheon Seminar 2

Maximizing the Efficacy of Nicotine Replacement Therapy

Richard D. HURT
Nicotine Dependence Center Mayo Clinic
The cigarette is the most efficient nicotine delivery system ever produced, and the arterial concentrations of nicotine achieved
from cigarettes cannot be reproduced by any current medicinal nicotine product. Thus, we as healthcare professionals will haveto be creative in the use of nicotine replacement therapy in order to achieve maximal success. It has been shown that single dose
nicotine patch therapy delivers doses of nicotine that are considerably less than produced by cigarettes. In fact when using serum
cotinine as a marker of nicotine intake, a single dose nicotine patch will achieve about 50% of the cotinine concentrations fromcigarettes. The arterial and venous concentrations of nicotine from a single nicotine patch are basically identical, at around 17
ng/mL,unlike that from a cigarette where the arterial spikes are extraordinarily high reaching concentrations of 80-90 ng/mL.
Thus, most smokers will be under replaced using single dose nicotine patch therapy.
Cigarettes smoked per day can be used as a surrogate for serum cotinine concentrations to determine the initial nicotine patch dose. Smokers smoking 10-230
cigarettes per day a nicotine patch dose of 14-21 mg may suffice while for smokers smoking 21-40 cigarettes per day the dose range will be from 21-42 mg/day
and for smokers smoking more than 40 cigarettes per day the starting dose should be at least two 21 mg patches, if not more. Using the patch as a base medication
which will deliver nicotine over a 24-hour period of time, we then supplement that with a short-acting nicotine replacement product (nicotine gum, lozenges,
nasal spray, inhaler) for withdrawal symptom control. This combination is necessary in most patients. Depending on the patient’s response, more creative uses of
nicotine replacement therapy will be required in order to achieve withdrawal symptom relief and sustained smoking abstinence. Further, short courses of nicotine
replacement therapy are not as effective as longer courses. When asked by the patient how long they need to use this medication, the answer should be: “As longas it takes!” This takes into account the neurobiological changes that occur with cigarette smoking, which take time (months) to reverse. It should be pointed
out that the nicotinic acetylcholinic receptors are left with an “indelible memory” of the rewards from smoking; therefore, urges to smoke (cravings) can go on
for an extended period of time. Sustained smoking abstinence is achieved and solidified after the patient is able to go through relapse situations comfortably andconfidently. During this presentation, cases will be presented to illustrate the “art of treatment” for patients with tobacco dependence.

Luncheon Seminar 3

Smoke-Free Workplaces Save Lives

Richard D. HURT
Nicotine Dependence Center Mayo Clinic
In 2011, the Global Smoke-Free Worksite Challenge was presented as a commitment at the Clinton Global Initiative in New York
City and was selected for a plenary presentation before all 1000 CGI members. The aim of the Challenge is to have companies
and governments recognize the hazards of secondhand smoke and the benefits of making their workplaces smoke-free. There are
now nine partners working in synchrony to encourage and assist others to implement smoke-free workplace policies.
In June 1987, after a year of planning, Mayo Clinic became one of the first large medical centers in the world to implement
a comprehensive smoke-free policy. The directive came from the Board of Governors in 1986, and the implementation wentsmoothly because of the top-down directive as well as the extensive communications provided for the 12 months leading up to
the implementation. Two and one-half years after the campus wide smoke-free policy was put into place, the smoking prevalence
among Mayo employees decreased significantly.
It is estimated that globally over 600,000 non-smokers are killed each year by secondhand smoke. Causes of death from secondhand smoke range from Sudden
Infant Death Syndrome in infants to lung cancer in adults. The biggest secondhand smoke killer is myocardial infarction. As little as 5 minutes of secondhand
smoke exposure causes endothelial dysfunction and continued exposure causes increases in platelet adhesiveness, both are factors in the initiation of myocardial
infarction. Smoke-free workplace laws have demonstrated a decrease in the incidence of acute myocardial infarction of over 30%. Thus, smoke-free workplacepolicies and laws can be implemented in corporations or in cities and countries resulting in tens of thousands of lives saved every year.

Luncheon Seminar 3(The Adoption of) Numerical Targets in Japanese Tobacco Control Policy and
How Japan's Ministry of Health Work Site Became Smoke Free

Yoko KOMIYAMA
Former Minister of Health, Labour and Welfare of JapanThe Yoko Komiyama Policy Research Council
Former Minister of Health, Labour and Welfare of Japan, Ms. Yoko Komiyama, will tell the story of how the Japanese
government overcame many challenges to strengthen its tobacco control policy, including raising the tobacco tax in 2010, andadopting numerical targets in 2012 to reduce smoking rates by 40 percent. She will also explain how she was able to makeJapan's Ministry of Health work site completely smoke free indoors by removing all indoor smoking rooms. As for the future,
Ms. Komiyama will share plans for Japan's parliament to revise the Industrial Health & Safety Law in early 2014 to require
employers to take steps to protect employees from the harmful effects of second-hand smoke.

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Luncheon Seminar 3

J&J’s Smoke-Free Policy and How Public and Private Organizations
Cooperate to Make Their Worksites Tobacco-FreeDavid GRAHAMInternational Government Affairs, Johnson & Johnson
Mr. Graham will share J&J experiences in implementing effective smoke-free and tobacco-free policies. As a leading partnerof Global Smoke-free Worksite Challenge, he will talk how public and private cooperate to work toward making their worksites
completely tobacco-free and assist other employers in going smoke free. He will also present the result of national survey of
exposure to second-hand smoke in workplaces in Japan.

Luncheon Seminar 4

Future Challenges of Tobacco Dependence Treatment from Japan Experience

Masakazu NAKAMURA
Osaka Center for Cancer and Cardiovascular Diseases Prevention
Tobacco use remains the most important worldwide cause of preventable death and disabilities. Nicotine is the cause of addictive
tobacco use, which causes serious health damages. In Japan, over 50 % of smokers say they want to quit and approximately 28 %make a quit attempt each year Unfortunately, over 80 % of quit attempts are unaided, resulting in point prevalence abstinence rate
at the following survey (average 6 months follow-up) of only 8 %. This illustrates the powerful force of tobacco addiction. Tobacco
addiction is best considered a chronic disease with repeated interventions over time before achieving permanent abstinence.
It is important to implement tobacco dependence treatment measures synergistically with other tobacco control measures. The
promotion of tobacco cessation and treatment of tobacco dependence are key components of a comprehensive, integrated tobacco
control program in FCTC. Support for tobacco users in their cessation efforts and successful treatment of their tobacco dependence
will reinforce other tobacco control policies.
There is clear scientific evidence that tobacco dependence treatment is effective and cost-effective. Pharmacotherapy for tobacco
dependence treatment is safe and effective and significantly increases the chance for long-term smoking abstinence compared with quit attempts unaided bypharmacotherapy.
In Japan, smoking cessation treatment service in outpatients has been started under health insurance coverage since 2006. The service consists of five treatment
sessions with counseling and pharmacotherapies over 12 week duration. The continuous abstinence rates at the randomly selected registered institutions in 2006
and 2008 were 32.6% and 29.7% respectively at 9 months after the end of treatment. The service is also proven to prevent relapse by half compared with on theirown. Despite of the presence of effective service, the utilization is still small.
To promote smoking cessation, it is essential to: (1) increase demand for cessation treatment by promoting tobacco control including media campaigns, higher
tobacco price and smoke-free environments, (2) improve the access to cessation services by increasing the number of registered medical institutions, (3) facilitate
the utilization through brief interventions at routine healthcare activities and proactive quitline services as the hub of a network of cessation resources, (4)disseminate effective treatment options to increase the likelihood of success, including combination therapy, harm reduction approach based on the UK NICE
guideline (June 2013) and development of innovative pharmacotherapies, (5) establish effective health professional training system.
In this presentation, future challenges of tobacco dependence treatment based on Japanese experiences and recent international movements will be provided.

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P-PL1-01 Effective Nationwide Networking and Social Movement in Aotearoa New Zealand
Prudence STONE1, Stephanie ERICK2, Skye KIMURA3
Smokefree Coalition1, Tala Pasifika2, Cancer Society of New Zealand3
Aotearoa New Zealand has a bold goal to become Smokefree by 2025 and a Roadmap to getting there. A parliamentary Inquiry in 2010 on the impact of tobacco
use upon Maori resulted in a government commitment to making Aotearoa New Zealand Smokefree by 2025. Now the sector is responding with busier networks
regionally and nationally, collaborating on more activities, while contributing to one widely consulted national strategy, aligned to three clear objectives. These
objectives are successful quitting, supply and demand reduction, and community engagement.
This presentation will provide New Zealand's latest examples of effective nationwide networking and social movement to achieve its next steps. At a national
level, Aotearoa New Zealand has a strong coalition of organisations known as the Smokefree Coalition. These organisations take the lead in mobilising the
public's support toward the objectives, providing evidence and rationale for every measure or "next step" upon the nation's Roadmap, via their vast net ofcommunications media and workforce champions. Member organisations are clustered around priority populations, such as Maori and Pacific communities,
where inequity caused by tobacco use exists.
The Cancer Society of New Zealand provides an example of a lead agency mobilising public support nationwide that achieves legislative change. Most recently,
The Cancer's Society was successful in enough social movement to drive the removal of tobacco products from retail display. Currently, the Cancer Society
applies the same mobilisation methods to continue the social movement's momentum, with a view to supporting government's regulation of tobacco packaging.
Tala Pasifika provides an example of a lead agency engaging the vast diversity of Pacific communities within Aotearoa New Zealand, to increase demand for
cessation services and protect children's exposure to tobacco. In 2013 a national leadership service for Maori will mobilise New Zealand's iwi communities andorganisations, and there also exists an active Asian Health Network in New Zealand also. Collaboration of activities amongst all of these organisations enables
a vision for this national network to become an Oceanic one, so that the Roadmap to a Smokefree 2025 in Aotearoa New Zealand carries on as a journey for theentire South Pacific region.

P-PL1-02 Tobacco Industry Surveillance Network in Southeast Asia: Stepping Up Tobacco Industry Counteraction
Worrawan JIRATHANAPIWATSoutheast Asia Tobacco Control Alliance
SEATCA has been implementing the SEATCA Industry Surveillance (SIS) initiative since 2009 in Cambodia, Indonesia, Lao PDR, Malaysia, Philippines,
Thailand and Vietnam. The objective is to build and strengthen a network on tobacco industry (TI) monitoring, alerting and countering (MAC) industry activities
based on FCTC Article 5.3 (Industry Interference) and 13 (TAPS). SIS employs a concrete and practical approach to support countries to increase MAC of TI:
1) A simplified online mechanism to monitor TI enables all countries (Focal Points and lawyers) to share information on industry interference and TAPS througha password-protected website. Strategic information provides developing counteraction at country and regional level.
2) Countries identify priority issues i.e. TAPS, Point-of-sale, CSR, and TI denormalization and implement a national strategy on TI monitoring and counteraction.
Short publications on issues monitored and a regional Newsletter are distributed regularly to partners to track TI tactics, advance tobacco control policy in theregion and apply lessons learned in their respective countries.
3) Focal points and lawyers meet at regional SIS workshops to share and update their local situation. Lawyers utilize these workshops to better understand how
TI interferes with policy development and circumvents tobacco control law and identify ways to counteract industry interference.
These MAC activities have had an impact at the country level. The Cambodian focal point countered arguments posed by TI in non-compliance of the Ad ban
decree. In Indonesia the Focal Point conducted a national workshop on CSR, the first of its kind, to challenge industry-related activities and handed over a
Declaration to the authorities. In Malaysia online promotions of tobacco products were discussed by the authorities based on evidence provided by the Focal
Point. Thai advocates conducted strong counter activities during public hearings on new legislation to ban TI related CSR activities which the industry tried
to undermine. Philippines advocates mounted strong opposition against an industry trade event, the Protobex, and in Vietnam, lawyers provided strong legal
arguments to support new legislation on tobacco control.
MAC enables good collaboration between countries and SEATCA. Through monitoring and countering TI interference, the tobacco control movement inSoutheast Asia as a whole has been further strengthened. This is crucial to repulse the aggressive challenges from TI which sees Southeast Asia as its big growthmarket.

P-PL1-03 Prevalence of Smoking in Students of Chulalongkorn University
Premtip THAVEERATITHAM, Nampung KUMSUPSIRI, Pantawit ARIYAWORACHAI, Prapon RUJIPORN, Thongsuk MANITSORN
Chulalongkorn University
Cigarette smoking causes many health problems for both first-hand smokers and second-hand smokers. The data from 1991-2006 showed that the smoking rate
in young people aged between 19 and 24 years which was the age range for undergraduate students had increased. The objectives of the present study were tosurvey the number of smoking students in the Chulalongkorn University and to evaluate the knowledge of the students about the harmful effects of cigarette.
The survey was conducted by a questionnaire via convenience sampling. The researchers handed to and waited for the completed questionnaire from 2,011
students which approximated 9% of the total students of each of the 19 faculties. The results indicated that the prevalence of current smokers was 2.6%. The
faculty that showed the highest prevalence of 10% was the Faculty of Architecture. Forty-four percent of the students started smoking in the age range of 1518 years while 40% of students started smoking in the age range of 19-21 years. In most cases, the motivation for starting smoking was curiosity (46%). Most
students smoked while they were at pub (64%), university (48%), and house (42%). Thirty-seven percent of students had the knowledge about the harmful effectsof smoking from classroom study. The percentages of the students who knew that cigarette smoking affected on respiratory, neurological, and cardiopulmonary
systems were 98%, 62% and 60%, respectively.
All data indicate that the university students, especially those who are not in the field of health sciences, are at high risk of involving with cigarette smoking. The
contributing factors are from the family, the university, and the students themselves. Therefore, all parties from university, faculty, and family need to inspect,teach, and produce activities as well as provide consultation in order to persuade students to decrease and quit smoking. Additionally, they should prevent newand ex-smoking students from involving with smoking in the future.
Key words : smoking, university, student

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P-PL1-04 Situation and Trends of Adolescent Smoking in Thailand:Results from 5 Waves of ITC-SEA (Thailand) Surveys
Pariya GAINROJ1, Buppha SIRIRASSAMEE1, Tawima SIRIRASSAMEE2, Ron BORLAND3, Geoffrey T. FONG4, David HAMMOND4
Mahidol University1, Srinakarinwirot University2, The Cancer Council Victoria3, University of Waterloo4
Background: Smoking increases with age, especially during the teenage years. Thai researchers have started under taken a longitudinal study. It is interesting
to surveillance of adolescent smoking behavior found to be interesting and significant
Objective: To explore the situation and trends of adolescent smoking in Thailand
Methods: Five cross-sectional surveys of Thai adolescent smokers aged 13-17 years old, using stratified multistage sampling over 5 regions of Thailand:
Bangkok, North, Northeast, Central and South. The sample was designed to be national representative and regional level which covered both rural and urban
areas in Thailand. The surveys involved 1,000, 962, 1,096, 958 and 961 adolescent at Wave 1, 2, 3, 4 and 5 respectively. The surveys were conducted in 2005,
2006, 2008, 2009 and 2011 respectively. The self-administered questionnaires were employed. Data was analyzed and compared using descriptive statistics
Results: Smoking prevalence among adolescents is 11.3 percent at wave 1 survey. This found to be increased in all the follow up wave surveys (15.0, 18.3,
21.5 and 22.4 percent at wave 2, 3, 4 and 5 respectively). The average age of first smoking the whole cigarette was 13.8 years at wave 1 survey. It also found to
be increased in all the following waves (14.5, 14.7, 15.2 and 15.3 percent at wave 2, 3, 4 and 5 respectively). 27 percent of adolescent smokers smoke cigarette
every day at wave 1 survey. This is dramatically increased in all the follow up wave surveys (44.0, 52.2, 59.7 and 73.5 percent at wave 2, 3, 4 and 5 respectively).
More than 90 percent smoke factory cigarette in all 5 survey waves. Only few smokes hand rolled cigarette. Most of adolescent smokes average 2-5 cigarettes
per day. This is found in all 5 waves. 45 percent of adolescent smokers reported at wave 1 survey that they sometimes/often smoke cigarette with their parents.
This also found increased in all the follow up waves (57.1, 60.7, 55.9 and 73.4 percent at wave 2, 3, 4 and 5 respectively).
Conclusion: Adolescent smoking in Thailand trend to be increased. The proportion of adolescent smoke everyday also increased in all follow up waves. The
factory cigarettes are mainly consumed. Anti smoking campaigns especially aimed at young adolescent should be implemented to prevent new smoker andcounseling service for adolescents who want to quite smoking should be provided.

P-PL1-05 Monitoring Political Discourse around End-game Goals: Using a Mix of Automated and Human Textual Analysis to
Enable an On-going Overview
Benjamin HEALEY, Richard EDWARDS, Janet HOEK
University of Otago
Background: In March 2011 the New Zealand government adopted a goal of making New Zealand an essentially smoke-free nation by 2025. Achieving a goalsuch as this will require the introduction of a range of policy measures that the tobacco industry and its allies will strongly contest. For this reason, end gamegoals depend not only on robust evidence but also on broad political support and, ultimately, inclusion in public discourse. As a result, mechanisms to monitor
political discourse are required to track uptake and dissemination of endgame goals. In-depth human analysis of political documents is time and cost intensive.
Hence, we explored using a mix of automated and focused human textual analysis of press releases and speeches to identify trends in goal mentions over time.
Objectives: To pilot a process for rapidly analysing large numbers of political documents, with the aim of monitoring references to a national tobacco end-gamegoal within national political discourse.
Methods: We analysed over 11,000 press releases and speeches by New Zealand members of parliament from April 2010 to July 2012. Two sources were used;
together, these provide reasonable coverage of such documents from New Zealand’s political parties. Computer algorithms were developed to detect mentionsof the 2025 goal, assign authorship to documents, and capture metadata such as the date of release. Human coding was used for a small proportion of documents
where automated assignment was flagged as ambiguous.
Results: Mentions of the goal and other tobacco issues rose around the time of the goal’s adoption by government. These reduced both in number and as aproportion of all discussions during an election period that followed, but rose again afterward. One politician accounted for the majority (over 70%) of specificgoal mentions and a substantial portion of other tobacco-related mentions during the period analysed.
Conclusions: Although exploratory, the results indicate that this methodology provides a useful on-going overview of political discourse relating to tobacco
end-game goals. It revealed that political discussion of the 2025 goal in New Zealand is currently heavily dependent on one politician, and highlights a need forthe tobacco control community to stimulate and maintain political discussion during election periods. Additional sources will be required to expand coverage ofpolitical discourse beyond releases or speeches captured by the pilot repositories used.

P-PL2-01 Effects of Parental Smoking during Pregnancy on Development of Childhood Cancers
Fumio BESSHO, Masako TANIMURA
Kyorin University
Background: There are several studies concerning the effects of parental smoking on occurrence of childhood cancers. There is considerable contradiction
among the results of those studies.
Purpose: This study performed to determine the effects of parental smoking on occurrence of childhood cancers, by using a large volume of data accumulated
in the Japan Children's Cancer Registry (JCCR).
Materials and Methods: The data of 32,044 cases diagnosed and registered to JCCR in 1969-2006 was used. Registration form in the periods of 1978-1984
includes mother’s smoking during pregnancy and the revised form in the periods of 1985-2006 includes mother’s smoking during pregnancy and smoking habitsof parents. We calculated odds ratios of presence of mother’s smoking during pregnancy or smoking habits of parents to absence such events.
Results: Odds ratios are 2.5 for reticuloendothelial cancers excluding leukemia and malignant lymphoma in years of 1978-1984 and 2.29 for endocrine tumors inyears of 1995-2006 in case of maternal smoking during pregnancy. For children born to mothers with smoking habits, odds ratios are 1.16 for leukemia and 1.48
for soft tissue tumors. For children whose father had smoking habits, odds ratios were 1.32 for bone tumors and 0.78, 0.74 and 0.73 for central nervous tumors,eye tumors and benign teratoma, respectively.
Discussion: One of reasons of contradictions seen in literatures may be relatively small numbers of subjects in such studies. Our study was conducted by usinglarge numbers of subjects and showed increased occurrence of some kinds of childhood cancers when mothers smoked during pregnancy and had smoking habits.
However, it was surprised that paternal smoking habits was linked to less occurrence of childhood cancers. This finding contradicted many studies which had
showed that childhood cancers might be rather linked to paternal than maternal smoking. Further studies needs to clarify effects of tobacco smoking of parents
and childhood cancers.

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P-PL2-02 Broadening the Scope from TC to NCDs, Ideas and a Case Study
Syed Mahbubul ALAM, Gaous PEAREE, Syeda Anonna RAHMAN, Rashedujjaman SHAMIM, Sharmin AKHTER
Work for a Better Bangladesh Trust
The issue of non-communicable diseases (NCDs) is currently generating much attention internationally. The question arises how much tobacco control activists
can contribute to NCD control and how to avoid the pitfalls of losing the tobacco control momentum in the face of the new interest in NCDs.
The major risk factors for NCDs involve lifestyles, including healthy eating and exercise. Governments can effectively reduce risky behaviour through policychanges. But many organizations are reluctant to work on policy issues and to take on major corporations that profit from unhealthy behaviours. Thus it makes
sense for those with experience in tobacco control to contribute their expertise to NCDs, to illustrate how advocacy can stimulate policy changes despite
opposition by powerful interests, for instance improving travel opportunities by foot and bicycle and making healthy foods more available than unhealthy ones.
Since tobacco use is a main NCD risk factor, there is no reason why tobacco control should be lost. By broadening our expertise, we may be able to contribute
more and gain more voice than by remaining within tobacco control alone.
In addition to its work on tobacco control, WBB Trust (Work for a Better Bangladesh) has worked on liveable cities, including promoting walking and cycling,with technical and financial assistance provided by HealthBridge. It made sense to apply expertise developed in tobacco control to NCDs. Initially staff
were reluctant as NCDs were a new, big topic but quickly realized the similarities in approach (fighting big industry, changing policies to create a healthierenvironment). WBB sent almost 3,000 letters to local government officers asking them not to serve soft drinks or fast food at events. We integrated NCD issues
into our national workshop on tobacco control and organized local workshops on NCDs. Many local NGOs were interested in broadening their scope and alreadyhad the appropriate skill set and population-based approach to the issue. The expanded agenda expands the power and ability of local NGOs to use their influencewith government. Also by making changes within local NGOs (getting them not to serve unhealthy foods), we are creating a ripple effect throughout the country.
Utilizing our tobacco control work as a model, the network provides an easy way to collect industry monitoring information (on fast food, soft drinks) fromthroughout the country.

P-PL2-03 Role of Tobacco Control Resource Center Project on Public Awareness Regarding Smoking
Phenprapa CHILAKUL1,2,3, Mondha KENGGANPANICH2
Action on Smoking and Health Foundation1, Mahidol University2, ThaiHealth Promotion Foundation3
The ThaiHealth Promotion Foundation provided critical assistance in establishing ASH Thailand’s Tobacco Control Resource Center in 2005. The Center was
created to serve as the focal point for producing media and other materials to support the rapid expansion of various tobacco control networks in Thailand.In
doing so, the Tobacco Control Resource Center enables tobacco control networks to use and distribute materials to support their advocacy works as well as
their other activities. The goal of this center is to create social awareness among the general public as well as provide updates on current social trends, specificdimensions and audiences such as producing media in local languages to reduce the communication gap. The Center produces various materials to facilitate
the wider audience easily access. A variety of media tools such as posters, pamphlets, stickers, media kits, advocacy kits, multimedia, animation and also a
website (www.smokefreezone.co.th) were created as a tool for partners to easily reach a larger audience through free online media. Moreover, it also encourage
the audience to play a role in producing the media in order to keep the content fresh and interesting. The center has continued developing on producing media
for taking apart in raising the knowledge and awareness on smoking among Thai people. Objective: To assess the accessibility of ASH Thailand’s Tobacco
Control Resource Center among the users and the influence of its media on public awareness regarding smoking. Method: Data were collected from the databaseof ASH Thailand’s Tobacco Control Resource Center between 2009 and 2010 and from all users during January to June, 2012, by mail questionnaire, andthen processed and analyzed by descriptive statistic. Results: Through the years, the Center’s efforts have been assessed and summarized to include: In 2009
the Center provided assistance to individuals and organizations 3,400 times, with 2,225 requests coming directly from tobacco control networks. In 2010, theCenter increased that number to 3,650 times, with 2,425 requests coming directly from tobacco control networks. The most frequent use was by schools andeducation personnel at 69.2%.Second highest use was by personnel from various organizations at 65.6%, while the general public followed at 48.7%, and local
communities at 20.8%. Up to 93.5% of those who received material agreed that the Center had helped create awareness among the public, while 66% believedthat it providesthe public with a better understanding of tobacco-related laws as well as their basic rights. Some 49% said they experienced less second handsmoke, and 83% had participated in smoke-free or quit smoking activities.  Conclusions:  The Tobacco Control Resource Center has played an important rolein providing support as well as simplifying the establishment and growth of tobacco control networks in Thailand. The Center also continues to extend support
effectively to personnel working in the field of tobacco control.

P-PL2-04 The Effectiveness of the Motivational Interviewing Program Related to the Smoking Cessation among Health Care
Providers, At Sanpasitthiprasong Hospital, Ubonratchathani Province Thailand
Wanpen DOUNGMALA, Wantanee THONGNUN, Malee NIMPONGPAN, Kwanpat RAUNGSIT, Supathita KONGSIN, Paungthong TECHASIRIKOSOL,
Kannika CHANTARUKHA, Jamchan POUNGCHAN
Sanpasithiprasong HospitalObjective: To evaluate the effectiveness of the Motivational interviewing program related to the smoking cessation among health care providers working at
Sanpasitthiprasong Hospital. The total number of 35 active smokers voluntarily enrolled into the study.
Materials and Methods: It is a quasi-experimental design. The first step was called “treatment period” which participants had to go through an individual
counseling from one to three times. A second step was called “Follow Through period” which would be followed 4 times within 6 month. In case, theparticipants could not be reached, the telephone contact was allowed. A research tool included Motivation Interview Program, Smoking history, VCD, brochure,figures related to cigarette dangers. All data was analyzed via percentage, Mean, S.D.
Results: There were totally 33 out of 35 smoking participants in the program. There were 19 smokers effectively quit smoking from 1 week to 6 month periods(57.6%). Noticeably, there was an improvement among smokers in Stage of Change status from “determination” to “action” levels after the implementation of
the first intervention and follow through in 1 to 4 weeks. Noticeably, there were only 14 smokers (42.4%) could be able to cut off cigarettes. The Stage of change
status at week 1 to 3 moved from “contemplation” to “determination.”
Conclusion: Overall, the Motivational Interviewing Program could be an effective tool to help smokers giving up smoking (57.6%). The quitters had only mild tomoderate nicotine addiction levels compared to those failed to quit smoking with severe levels of nicotine addiction. Among unsuccessful smokers, they should
particularly receive an adjunctive treatment including, medications to help them quit smoking effectively.
Keywords: Motivational Interviewing, Smoking Cessation, Sanpasitthiprasong Hospital, Ubon Ratchathani.
Correspondence to: Thongnun W, Smoking Cessation Clinic, Department of Psychiatry Sanpasitthiprasong Hospital, Ubon Ratchathani Province, Thailand.
Phone 66894283019, E-mail: wantanee64@gmail.com

119P-PL2-05 What is Necessary to Make Smoke-free Society in Japan?
Kazunari SATOMURA, Toshitaka NAKAHARA, Suketaka IWANAGA, Megumi NOAMI, Keiko KUSAKA, Kazuyoshi HARANO
Kyoto University
In Japan, smoking rates are gradually decreasing for these fifty years. After the Framework Convention on Tobacco Control came into effect, several measures
were put into effect in Japan. Also in Healthy Japan 21, which is health promotion framework in Japan, quitting smoking is one of the main targets of it. However
the rates of smoking are not reduced drastically in recent years. To clarify the reason of this, several facts were gathered.
(Methods)Several facts which have a relation of smoking were gathered from newspapers, magazines, internet and so forth.
(Results)
1. Prices of cigarettes were raised about 33% in 2010. Before this time, percentage of the price increase was under 5%. The price of popular cigarettes is 6
US$. Some smokers changed the brand to cheaper ones which are 3 US$ after the price increase. To reduce smoking rates, these cheaper ones should be
stopped selling.
2. Warning on tobacco packages is scientific but too difficult to understand. What is written on packages is recognized as an advertisement and exaggerated
expression such as “ Tobacco kills” will not be allowed
3. There are several anti-smoking groups, but their cooperation is not so popular.
4. There are several scientific societies for anti-smoking, but their cooperation is not so popular. There is a standard manual for quitting smoking made by fourscientific societies, but it is based on medication and lacks other health educational methods.
5. Over 50% persons who want to stop smoking by medication is given Varenicline, but evaluation of its side effects is not yet clear.
(Discussion)Even now, Ministry of Finance has over 50% of stocks of Japan Tobacco, which is the only enterprise of tobacco in Japan. And about 65% of
tobacco price is the tax. Cooperation of the government is limited except department of health.
Considering present situation of anti-smoking, cooperation of groups and/or scientific societies is necessary and important. Each groups or societies havespecialties. Approving of their specialties and leading to smoke-free society are needed.
(Conclusion)To make smoke-free society, anti-smoking groups and societies should cooperate.

P-PL3-01 The Impact of 2009 China Cigarette Tax Adjustment on Cigarette Retail Prices, Cigarette Class/Grade Choice andCigarette Consumption
Jidong HUANG1, Rong ZHENG2, Frank J. CHALOUPKA1, Geoffrey FONG3,5, Qiang LI3, Yuan JIANG4
University of Illinois at Chicago1, University of International Business and Economics2, University of Waterloo3, Chinese Center for Disease Control andPrevention4, Ontario Institute for Cancer Research5
In May 2009, the Chinese central government increased its cigarette excise tax rate at the producer level. In addition, it imposed an additional 5% ad valorem
cigarette excise tax at the wholesale segment. While the main purpose of this tax increase was generating tax revenue, it was the first time that China adjusted its
cigarette tax policies since it ratified FCTC in 2006.
The goal of this study is to investigate how the price and consumption levels of different class/grade cigarettes change after the 2009 cigarette tax increase in
China. Multivariate analyses were conducted using the International Tobacco Control China Survey data (the ITC China Survey).The ITC China Survey is alongitudinal survey of adult smokers in seven cities in China: Beijing, Changsha, Guangzhou, Kunming, Shenyang, Shanghai, and Yinchuan. In each city, 800
smokers were surveyed in each wave. The first three waves of the ITC China survey data were used in this analysis: wave 1 (conducted between April to August2006), wave 2 (October 2007 to January 2008) and wave 3 (May to October 2009). Various aspects of smokers’ self-reported cigarette prices and consumption
levels were analyzed. We found that the 2009 cigarette tax adjustment reduced wholesalers’ profit margins. However, the reduction in profit margins wasmore pronounced among cheaper cigarettes. As a result, it provided incentives for cigarette manufacturers in China to favor the production of more expensive
cigarettes. While statistically significant changes were not detected in the average retail prices within each class after the tax increase, we found that the share ofsmokers who reported smoked cheaper cigarettes dropped after the 2009 tax adjustment, and the overall average self-reported cigarette prices increased after the2009 tax increase. In addition, the cigarette consumption decreased among those who reported smoked more expensive cigarettes after the tax increase. However,the cigarette consumption increased among those who reported smoked cheaper cigarettes after the tax increase. The overall change in cigarette consumption
was not statistically significant. Future tobacco tax policies in China should take into account their influences on both the demand and the supply side of cigarette
consumption, with the goal of increasing tobacco product retail price levels and reduce overall tobacco use.
Relevant Sessions: PL3 Tobacco Price and Taxation

P-PL3-02 Cigarette Retail Price Variations in China: Evidence from the International Tobacco Control China Survey
Jidong HUANG1, Rong ZHENG2, Frank J. CHALOUPKA1, Geoffrey FONG3,5, Qiang LI3, Yuan JIANG4
University of Illinois1, University of International Business and Economics2, University of Waterloo3, Chinese Center for Disease Control and Prevention4,
Ontario Institute for Cancer Research5
Cigarettes are sold in a variety of retail outlets in China. Depending on the types of retail outlets, retail level taxes on cigarettes are levied at different levels, which
could in turn influence cigarette retail prices. The goal of this study is to examine whether there are differences in cigarette prices across different retail outlets
in China and discuss the factors that contribute to these differences, if any, and implications on smoking behavior in China. Self-reported cigarette retail prices
were examined in five type of retail outlets (convenience stores and gas stations, supermarkets, tobacco shops, street vendors, and other types of retail outlets)
employing multivariate analyses using the International Tobacco Control China Survey data (the ITC China Survey).The ITC China Survey is a longitudinalsurvey of adult smokers in seven cities in China: Beijing, Changsha, Guangzhou, Kunming, Shenyang, Shanghai, and Yinchuan. In each city, 800 smokers weresurveyed in each wave. The first three waves of the ITC China survey data were used in this analysis: wave 1 (conducted between April to August 2006), wave 2(October 2007 to January 2008) and wave 3 (May to October 2009). Survey waves, cities, and the quantity of purchase (pack vs. carton) were control for when
examining the differences across different retail outlets. Close to 50% of survey respondents reported purchasing their last pack of cigarettes from convenience
stores and gas station, followed by tobacco shops (21.3%) and supermarkets (21%). About 7% reported purchasing from street vendors. Multivariate analyses
reveal that cigarette retail prices differ significantly across different retail outlets in China, with the highest prices observed in other type of retail stores, followedby supermarkets, tobacco shops, and convenience stores and gas stations. Cigarettes purchased from street vendors were the cheapest. The low price cigarettes
from street vendor may reflect the low quality of cigarettes, and it also may be due to avoidance of retail level taxes. Equalizing retail level cigarette taxes acrossdifferent retail outlets may reduce the price differentials across different retail outlets. The results of this study have implications for China’s future cigarette tax
structure adjustments.
Relevant Sessions:  PL3 Tobacco Price and Taxation

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P-PL3-03 Communication Strategy on Tobacco Tax Reforms: The Philippines’ Experience
Florante E. TRINIDAD
World Health Organization Office of the Representative in the Philippines
The Philippines has one of the lowest priced tobacco products in the world. In addition to being cheap, cigarette prices are classified according to four tiers; low-priced, medium-priced,
high-priced and premium-priced. After years of intensive lobbying for tobacco tax reforms, the legislature passed in December 2012 a much-needed bill that will remove the Philippines
eventually from selling the cheapest brands of cigarettes in the world. From four tiers, tax structure will be reduced to two tiers in 2013 (the first year of implementation) and finally tosingle unitary in 2017. Cigarette prices increased significantly on average by19% over 2013-2020 and indexed to inflation to meet the target objectives on reduction of tobacco-relateddiseases and death and on generation of revenues to fund the priority program on universal health coverage of Filipinos.
What messages worked to convince the legislators to pass the tobacco tax reforms?
In the entire campaign, there were concerted efforts from both government and non-government organizations to frame “sin tax” as “anti-cancer tax.” The battle cry became: “Sin tax
is anti-cancer tax.” Media practitioners alluded “sin tax bill’ as “anti-cancer bill.” The following 8 key messages were proven effective in the Philippine setting:
1. Sin tax is anti-cancer tax.
2. Senators must put health above other considerations.
3. Every hour, one person dies from lung cancer in the Philippines.
4. Every cigarette contains 70 known carcinogens.
5. Second-hand smoke kills.
6. Tobacco causes other diseases that kill Filipinos.
7. Taxes will reduce tobacco use among the youth and children and will prevent early death among Filipinos, especially the poor.
8. Higher taxes will protect the health of children and youth.
Primers were specially prepared for pro-health citizens, nurses, civil society, hospital chiefs, local chief executives, midwives, medical associations and regional Dept of Healthdirectors containing these 8 key messages and were widely disseminated using radio, print and social media.
It is hoped that with the new law, the prevalence of adult smoking will decrease from 28.3% to 23.3% representing 2.4 million fewer adult smokers.
Given the new law which covers both alcohol and tobacco products, the projected revenues are 33.96 billion pesos in 2013, 42.86 billion in 2014, 50.63 billion in 2015, 56.86 billion
in 2016 and 64.1 billion in 2017 with a total of 248 billion pesos in 5 years. Revenues from tobacco products is projected at 23.4 billion in 2013, 29.6 billion in 2014, 33.4 billion in2015, 37 billion in 2016 and 41 billion in 2017.
The tobacco industry voiced strong opposition in every step of the way but in the end, health prevailed.

P-PL3-04 How Much the Appropriate Tobacco Price Would be? -Conjoint Analysis for GENERAL Public in Japan
Ataru IGARASHI1, Rei GOTO2
The University of Tokyo1, Kyoto University2
BACKGROUNDS: In Japan, government gradually raising Tobacco tax. Most recent tax raising was implemented in OCT2010. Tobacco price raising, or
tobacco tax raising will affect both the smoking rate and tobacco tax revenue. Although there were several research for price elasticity of tobacco by which we
can forecast both factors, there is virtually no research for identifying ideal smoking rate and tobacco tax revenue amount.
OBJECTIVES: To conduct conjoint analysis to determine how the general public value various aspects around tobacco and to seek "ideal" tobacco price in whichpeople's preference is maximized.
METHODS: Through pilot studies, we identified four factors, i.e., smoking rate of whole population (-60%, -40%, -20%, -10%, unchanged. current rate:
19.5%), anti-smoking policy for youths (strengthened / unchanged), Total tobacco tax revenue (-20%, -10%, unchanged, +20%, +40%), purpose of tax raising(no restriction / exclusively spent for anti-tobacco policy). We chose 25 hypothetical situation from 5x2x5x2=100 patterns with orthogonal planning method.
1,077 participants, including both smokers and non-smokers, were responded via web survey system. We adopted panel-logit model to estimate coefficients foreach factor.
RESULTS: All 4 factors significantly influenced peoples' preferences. Coefficients for each factor were as follows; smoking rate of whole population: -1.138(favourable for decreasing) , anti-smoking policy for youths: 1.178 (favourable for strenghthening), tobacco tax revenue: 1.568 (favourable for increasing) andpurpose of tax raising: -0.547 (favourable for no restriction), respectively.
By applying the price elasticity of tobacco, we can predict both whole smoking rate and whole tax revenue for given unit price of tobacco. Therefore, we cancalculate implicit people's preference for specific tobacco price with our regression model. Given the situation that price elasticity for whole tobacco demands
was varyed -0.3, -0.4 and -0.5, "ideal" tobacco prices for general public, in which peoples' preference was maximized were JPY1,000, JPY850 and JPY750,
respectively.
CONCLUSIONS: Judgeing from peoples' preference, there would be some room for additional tobacco-tax raising in Japan.

P-PL3-05 How Much Various Anti-Tobacco Policies Would Affect Smokers' Attitudes? -Conjoint Analysis in Japan
Ataru IGARASHI1, Rei GOTO2, Takashi FUKUDA3The University of Tokyo1, Kyoto University2, National Institute of Public Health3
BACKGROUNDS: Implemeting anti-tobacco public policies, as well as tax raising, can affect smokers’ willingness to quit smoking. However, unlike tax raising,among which various analyses for price elasticities were already available, there were few analyses to measure the effect of various anti-tobacco policies, otherthan tax raising.
OBJECTIVES: To conduct conjoint analysis to estimate how much various anti-tobacco policies would affect smokers’ attitudes.
METHODS: We identified five factors, i.e., Tobacco prices (JPY400 (unchanged), JPY500, JPY600), Fine for smoking in public places (none / JPY2,000),
Health insurance coverage for smoking cessation therapies (exclusive for highly nicotine-dependent smoker (current situation), expand to all smokers including
youth and hospitalized smoker with co-payment, expand to all smokers without co-payment), Accessibility for smoking cessation therapy (only for authorised
hospitals and clinics / available in every hospital, clinic and pharmacy), and Warning messages on tobacco packages (current situation / enlarged). We chose 26
hypothetical situation from 3x2x3x2x2=72 patterns with orthogonal planning method. 982 smokers in “Smokers’ Cohort”, established in Osaka, were enrolled
in the mail survey. We adopted panel-logit model to estimate coefficients for each factor.
RESULTS: All 5 factors significantly influenced smokers’ willingness to quit smoking. Coefficients for each factor were as follows; Price raising: 0.03
(favourable for raising) , Fine implementation: 1.66 (favourable for implementing), Health insurance coverage: 0.54 (favourable for expansion), Accessibility:
0.47 (favourable for expansion), Warning message (0.32), respectively.
On condition that price raising would be inplemented without any other policy, even the price would be raised to JPY500 and 600, only 3.6% and 40.0% of
smokers would quit smoking, respectively. However, if it would be done with other policy, smokers were thought to be more likely to quit it. For example, if
price raising would be done with Fine, the proportion would be 16.4% for JPY500 and 77.8% for JPY600.
CONCLUSIONS: Various anti-tobacco policies other than price raising can reinforse smokers’ attitude to quit smoking. Tobacco price raising should be donewith other policies, to lower the smoking rate.

121

P-PL3-06 Is Employment in Bidi Manufacturing a Concern for Bidi Taxation?
Nigar NARGIS, Ayda A YUREKLIWorld Health Organization
Bidi is a popular smoked tobacco product in Bangladesh and India. In both countries, bidi is way cheaper and is taxed at a much lower rate than cigarettes. Raising
the tax on bidi and making its price comparable to that of cigarettes are, therefore, felt as natural steps towards harmonization of tobacco taxation across tobacco
products. Because of the high labor-intensity of bidi rolling, bidi manufacturers often raise the concern that raising tax on bidi would cut down bidi consumption
and production resulting in loss of employment and income of those employed in bidi industry. The bidi industry uses this argument to earn political support
against increase in bidi tax. This hurdle on raising the tax on bidi has resulted in the fall in the real price of bidi which is expected to encourage bidi smoking andimpose greater burden on public health.
In order to assess the possible impact of higher bidi tax on the employment in bidi industry, WHO has collaborated with the National Board of Revenue of theGovernment of Bangladesh to undertake a study on bidi workers in Bangladesh. Based on data available from this study, this paper estimates the full-time
equivalent employment in bidi industry and compares it to the total manufacturing employment in the country.
The second step is to estimate the output elasticity of employment that shows how much employment loss will occur following a given percentage reduction inbidi production attributable to reduction in bidi smoking from a given tax and price increase. With price elasticity of demand for bidi available from secondary
source, the paper estimates the reduction in bidi smoking from the tax and price increase and translates it into reduction in bidi production. This also helps
estimate the impact on government revenue from bidi taxation.
Finally, the paper explores the alternative livelihood options of displaced bidi workers. The paper suggests that the revenue generated from higher tax on bidi
can be earmarked to generate economically viable employment and income in order to rehabilitate these workers following Article 17 Guidelines of WHO
Framework Convention on Tobacco Control. This way the adverse socio-economic consequence for bidi workers from raising bidi tax can be avoided while
discouraging bidi consumption and earning better health outcome from reduced tobacco consumption.

P-PL3-07 The Impact of Cigarette Tax and Price Policy on Tobacco Industry Behavior ---Disclosing the Indurstry’s Profit Margin
in Each Segment
Rong ZHENG1, Jidong HUANG2, Song GAO3, Frank J. CHALOUPKA2, Geoffrey T. FONG4,5, Qiang LI4,6, Yuan JIANG6
University of International Business and Economics1, University of Illinois at Chicago2, Central University of Finance and Economics3, University ofWaterloo4, Ontarion Institute for Cancer Research5, Chinese Center for Disease Control and Prevention6
World experience has demonstrated that the most effective single measure to reduce tobacco use is tobacco taxation and price policy. However, the effectivenessof a cigarette tax on tobacco use in China is limited because the increased tax can’t be shifted to the retail price given the cigarette pricing mechanism that exists
under China’s tobacco monopoly system and excise tax-inclusive tax base design. Although the cigarette excise tax adjustment in 2009 hasn’t had much impact
on cigarette prices for given cigarette brands and specifications, it has had a large impact on the tobacco industry’s behavior and has changed the cigarette supply
structure dramatically, raising the average retail price of cigarettes and overall tax share. This study is going to combine ITC China survey data and STMA
industry inner data including cigarettes annual allocation plan data and financial data to examine the profit margin of tobacco industry in each sector, so that toestimate the maximum level of excise tax rate for tobacco industry to offset the increased tax with profits. The disclosing of the industry’s profit margin helps
policy maker to set up target of increasing cigarettes excise tax rate to ensure the effect of tax policy on cigarettes retail price under the current tobacco monopoly
system. This study will also analyze tobacco industry behavior upon the tax policy change. We found significant transformations upon tax change on the supply
side such as the consolidation of cigarette brands, and change with the market share of different priced level cigarettes. The results of this study helps policy
maker to take into account of the influences of tobacco tax policy on both the demand and the supply side of cigarette consumption, with the goal of increasing
cigaretts retail price and reduce overall tobacco use in China.
Relevant Sessions:
S11 Tobacco Price and Taxation (1)S12 Tobacco Price and Taxation (2) Country experiences

P-PL3-08 Contribution of Sale to Minors to Tobacco Industry and Government Revenues - A Case of India
Pranay LAL, Sonu GOEL, Deepak SHARMAInternational Union Against Tuberculosis and Lung Disease, Postgraduate Institute of Medical Education & Research
In 2010, the Global Adult Tobacco Survey for India revealed that nearly 40 percent of current smokers and 42 percent of current chewers were initiated into
tobacco use before they were of the legal age of 18 years old. There is strong evidence to suggest that those who initiate earlier have lower probability of quitting
the use of tobacco during their lifetime. The tobacco industry is aware of the importance of recruiting underage consumers and it makes every attempt to selland solicit tobacco products to them. How much business revenue does the tobacco industry earn from sales to minors? How much does the government gain interms of taxes? We estimate the number of underage users and the contribution they make to the sale and tax revenue to the industry and the government fromconsuming cigarette, bidi and chewing tobacco products.
Methods: We rely on using data from the nationally representative data from the Global Youth Tobacco Survey (GYTS) in 2006 and GATS (2008). We use themean units of tobacco products (cigarette and bidi sticks, chewing tobacco products) consumed annually in underage group (≥15 to 18 years). We use industry
data for volumes and value (in Indian rupees), and Government of India data for tax revenues to derive revenues earned by industry and government from tobacco
use by minors in 2011.
Results: Overall 19% of all revenue to tobacco industry (chewing 27%, bidis 22%, 9% cigarettes) and 11% of governments' tax revenues comes from sale tominors.
Conclusion: A significant number of minor become lifelong users and impose an unacceptable cost in terms of morbidity and morbidity from tobacco use.
Industry's assurance, and legislation and enforcement measures by the government currently may be ineffective in reducing new recruitment of underage tobaccousers. Stricter enforcement of sale to minor rules and compliance checks are needed to reduce this. The (Union and state) government needs to put in place added
measures to counter the perverse revenues in makes from underage sales.

122

P-PL3-09 Improper Tobacco Taxation Benefiting the Tobacco Industry in Bangladesh
Taifur RAHMAN
Campaign for Tobacco-Free Kids
Bangladesh has one of the most complicated tobacco tax systems in the world that enables the tobacco industry to play around it keeping the tobacco prices
extremely low. The various types of tobacco products in the country add further complicacies to the system. Apart from cigarettes, other tobacco products
include hand-rolled cigarettes (called ‘bidi’) and smokeless tobacco products e.g. chewing tobacco and powdered tobacco. All these tobacco products are
extremely cheap due to absence of proper taxation.
Taxes on cigarettes are not unified for all brands in Bangladesh. Cigarettes are divided by price tiers into four categories and different tax rates are applicable ondifferent price tiers. In recent years, the government has been increasing the value of the price tiers every year instead of increasing the tax rates across the board.
This increase in price tiers gives the tobacco industry opportunities for earning additional profits every year while the government is loosing precious revenues
that they could earn if tax rates were increased instead of the price tiers. This approach of taxing tobacco contributes to widening the existing price gaps between
the most expensive and cheapest brands allowing further scopes for smokers to switch downwards. Thus, the benefits of the current approach of tobacco taxationin Bangladesh are going to the cigarette manufacturers.
While cigarette taxation is facing such difficulties, taxing bidi (the local hand-rolled cigarettes) face a lot of political challenges as the bidi producers have beenable to mobilize sufficient political support using the argument of employment of poor people in the bidi factories. Thus, bidi is subject to the lowest tax rates
among all tobacco products in Bangladesh. The actual tax burden is even less due to the improper base price. Instead of retail price, bidi is taxed on ex-factory
price, which reduces the tax burden to almost half of the official rates. Although smokeless tobacco products are subject to higher tax rates than bidi, the systemof tax collection is too weak to generate any real impact of increasing the tax rates on these products.
The proposed paper will highlight these systemic problems in the tobacco tax structure in Bangladesh and show how these loopholes are ultimately benefiting the
tobacco industry. The paper will present an estimation of the amounts of profits that are drained to tobacco companies through adjusting price tiers of cigarettes
instead of increasing tax rates.

P-PL3-10 The Impact of Tobacco Tax Increase on Affordability Revenue and the Implication for Tax Policy in Vietnam
Hoang Anh T. PHAM1, Hien T. LE1, Nam V. HUYNH2, Vang V. DANG2
HealthBridge Canada1, Ministry of Finance2
Background: The growing prevalence of tobacco use is a large contributor to the increasing burden on public health and its economy. Tobacco tax measures
Increaseof incomeof thesales profit andrevenues
byand
the public
price increasethat raise cigarette prices through increases in excise tax are an effective intervention tool
to reduce
cigarette
affordability
and tax
enhancefiscalhealth(tax-rates raising) of the tobacco from October, 2010
gains for the country.
Objective: To explore the changes in the affordability of tobacco between 1998 and 2009 and the impacts of tax increases on that affordability and government
Hiroshi Nogami
Coalition on a Smoke-free Environment for Kids in Japanrevenue
Method: The Relative Income Price (RIP) measure and the “minimum wage” method were used to examine tobacco affordability; Van Walbeek’s simulation
Purposemodel was used to analyse the fiscal and public health impacts of tobacco tax increases;In Japan, the male smoking rate and the number of tobacco sales are
Result: Between 1998 and 2009, nominal cigarette prices increased for the most continuing
expensivedecreasing
brand, 555for(from
VND 11,000 to 21,000), most popular brand,
latest ten years. The tobacco sales volume (including the
VINATABA (from VND 6,200 to 12,000) and cheapest brand, Thang Long (from VND1,400
VND 2,800).
In theUnlesssame period,there
a 4-foldtax) is also todecreasing
gradually.
the ratesof awascigarette
taxgrowthand theinpricereal per capita Gross Domestic Product (GDP), as well as an increase in personal incomes
andrapidly,
purchasing
are raised
the tax revenues and a sales total (profit of the tobacco industry)
power in Vietnam. Thus despite the two-fold nominal price increases for all brandtheir real prices have generally remained unchanged with awillcategories,
decrease rapidly.
downtrend over the same period, indicating the growing affordability of cigarettes. SinceSince
2008,about
the excise
rate forcigarettes
and110cigars65% of was
36% taxof priceincrease(aboutyenhasperbeenbox)setof atcigarettethe pre-tax, ex-factory price. On average, total taxes on cigarettes in Vietnam accountfor almostof thesale price.
If the excise
rate is increased
by ofraisedfor the45%
first timein retailfour years
from October,
2010,tax
transitionof the volume
5% to 50%, resulting in an average retail price increase of 30.4%, there would only tobacco
be a marginalincrease
5,250 towere
VND
6,846. Thus
cigarettesales, pricea price,a profit,fromand VND
tax revenues
analyzed
and considered.
prices are still relatively low, suggesting that the excise tax rate should be regularly raised to a higher percentage in order to reduce cigarette affordability. Thislevel of increase however would lead to an immediate revenue increase by 5.2% to Result
46.9% (VND 14,150 billion)
By theincrease(tax
rateonraised)of thein Octoberto2010,
a selling
Conclusion: Cigarettes became progressively more affordable in Viet Nam between 1998
andprice
2009.
Current
taxes
tobaccoaretobacco
not functioning
decreasevolume,tax revenues
andtax omission tobacco
sales increased
in 2011andsmoking prevalence in the country. A progressive increase in the excise tax would resultin cigarettea significant
increase ofgovernment’s
tax revenue
overthe2012compared with 2009 (in the previous year of 2010). In 2011, the number cigarettes
years and will save the lives of peopleof sales decreased 16%. On the other hand, the selling volume and the cigarette
tax revenues increased 16-17% (increasing total tax revenues of 816 billion yen inthree years from 2010 to 2012), and the tax omission sales (including profit)
total profit of
317 billionof
yentheincreased
13%Increase(increasingin threeyears).from
P-PL3-11 Increase of Income of the Sales Profit and Tax Revenues by
the Price(Tax-rates
Raising)
Tobacco.
Tobacco industry did not say the increase in a sales return by tobacco price
October, 2010
increase, and had denied that tax revenues increased. Because the income of theHiroshi NOGAMI
cigarette tax is increasing, they should change the sweeping measures of tobacco,and convert the radical measures of change of employment, crop rotation, etc.
Coalition on a Smoke-free Environment for Kids in Japan(email muen@silver.ocn.ne.jp)

100 million yen
the number of sales forcigarettes （ 10million）

45,000

タバコ販売本数the volume of sales for cigarettes

タバコ販売代金the selling pricetax revenues
sales income of tobacco industry

タバコ税収（消費税込み）
税引き純販売額

40,000O c tobe r 2 0 1 0
4 0 ％ in c re ase in tax rate s↓*16％
increasecomparedin 200935,00030,000* + 17％25,000*- 16％
20,000* + 13％15,000

Fig1 Transition of the selling price of cigarettes andtax revenues, income of tobacco industry

20
12

20
11

20
10

20
09

20
08

20
07

10,00020
06

Purpose: In Japan, the male smoking rate and the number of tobacco sales arecontinuing decreasing for latest ten years. The tobacco sales volume (including the tax)
is also decreasing gradually. Unless the rates of a cigarette tax and the price are raised
rapidly, the tax revenues and a sales total (profit of the tobacco industry) will decrease
rapidly. Since about 36% of price increase (about 110 yen per box) of cigarette wasraised for the first time in four years from October, 2010, transition of the volume of
tobacco sales, a price, a profit, and tax revenues were analyzed and considered.
Result: By the price increase (tax rate raised) of the tobacco in October 2010, a sellingvolume, cigarette tax revenues and tax omission sales increased in 2011 and 2012
compared with 2009 (in the previous year of 2010). In 2011, the number cigarettesof sales decreased 16%. On the other hand, the selling volume and the cigarette tax
revenues increased 16-17% (increasing total tax revenues of 816 billion yen in three
years from 2010 to 2012), and the tax omission sales (including profit) increased 13%(increasing total profit of 317 billion yen in three years). Tobacco industry did not
say the increase in a sales return by tobacco price increase, and had denied that tax
revenues increased. Because the income of the cigarette tax is increasing, they shouldchange the sweeping measures of tobacco, and convert the radical measures of changeof employment, crop rotation, etc. (email muen@silver.ocn.ne.jp)

year※ included consumption tax

123

P-PL3-12 Low Cost of Manufactured Cigarettes in Cambodia Targets the Poorest and Youngest Smokers
Daravuth YEL1, They KHEAM2, Pramil N. SINGH3
World Health Organization1, Ministry of Planning2, Loma Linda University3
The National Adult Survey of Tobacco Use in Cambodia (NATSC 2011) was completed by the National Institute of Statistics, Ministry of Planning during 20102011 and interviewed 15,615 adults over 15. Data analyzed by WHO Cambodia found the extremely low price of manufactured cigarettes, averaging only 0.20
USD (95% CI [0.19 to 0.23]) per pack, the lowest in the Western Pacific Region. The price out competes the hand-rolled cigarettes (0.07 USD for a bundle), sothat 85.7% of cigarettes last purchased by smokers was a manufactured pack. This pricing had great impact on the poorest and youngest smokers. Of the 99.1
million USD annual expenditure on manufactured cigarettes, 41.9% was spent by adults earning 2 USD per day or less. They spent about 6 USD per month (10%or more of their income) on tobacco, equivalent to the price for 7-8 kilograms of rice, highlighting the contribution of smoking to poverty and undernutrition.
This low price may also contribute to the recent increase in smoking among youth. NATSC 2011 indicated that 1 out of 5 of the youngest smokers (age 15 to19) started to smoke daily before age fifteen, indicating that manufactured cigarettes was affordable even to those under 15.
The results suggest that the price of manufactured cigarettes needs to be raised to decrease the devastating health and economic consequences among the mostvulnerable populations. Since NATSC 2011 findings indicated that compliance with tax stamps has been achieved for 95% of the packs, taxation remains aneffective method to increase the price.
The data was from analysis of a recent survey that had nationwide representativeness, and timely publicizing of the data may have beneficial impact on the
taxation policy in Cambodia.

P-PL3-13 Analyzis of Tobacco Excise Policy in Indonesia : Bringing the Health Objectives Back In
Abdillah AHSAN
University of Indonesia
Background : Smoking prevalence in Indonesia is increasing recently. Smoking prevalence among adults in Indonesia jumped from 27% in 1995 to 34.7% in
2010. For the same period the smoking prevalence for men increased from 53% to 66% while for women increased from 1.7% to 4.2%. Tobacco tax is considered
to be the most effective instrument to control its consumption.
Objectives : To describe tobacco excise tax system in Indonesia and to asses the effectiveness of tobacco excise policy in term of tobacco control
Method : policy analysis of the ministry of finance regulation about the tobacco excise tariff in 2009-2012.
Result : According to law No. 39 year 2007 about excise the objectives of excise policy is to control its consumption. This law also stated that the maximum
excise tariff is 57% of the retail price which is lower than recommended by WHO, 2/3 (67%) of retail price. During the 2009-2012 period, average tobacco excise
tariff has increased from 38% in 2009 to be 54% in 2012. The tiers of excise tariffs also reduced from 25 tiers in 2009 to be 20 tiers in 2012. Tobacco excise
system in Indonesia has failed to increase the cheapest price of cigarette from 2008-2012. Tobacco excise system in Indonesia is complicated that create wide
gap between the cheapest and the most expensive price cigarette.
Conclusions : Tobacco excise in Indonesia must be increased substantially to control its consumption. In addition, tobacco excise system in Indonesia must be
simplified to maximizes the health benefit of increasing tobacco excise.

P-PL3-14 Curbing Tobacco Epidemics by Tobacco Taxation in Lao PDR
Maniphanh VONGPHOSY, Sophapan RATANACHENA, Jennie L. REYESSoutheast Asia Tobacco Control Alliance
Lao PDR ratified the FCTC in 2006, followed by the passage of the Tobacco Control Law in 2009. Despite implementing a smoking ban in work places andpublic places (FCTC Article 8) and tobacco excise taxes to reduce tobacco consumption, smoking prevalence rates among youth (13-15 years old) steadily
increased from 2003-2011, from 11.2 % to 14.3% among boys, and 0.7%-1.1% among girls1. Similarly, health care costs are on the rise, with the total in-patient
health care costs amounting to USD 3,341,577 in 2007, representing 0.8% of Lao PDR’s GDP and 22% of Lao PDR’s health expenditure2. If compared withthe country’s tax revenues, health care costs are equivalent to 68.1% of the total revenues3. Unless stronger tobacco control measures are put in place, thegovernment will continue to bear the increasing cost of smoking-related health care in Lao PDR.Recognizing tobacco taxation as an effective tool for reducing
consumption, this paper describes Lao PDR’s tobacco tax structure and collaborative efforts between civil society and the government towards raising taxes andestablishing a Tobacco Control Fund. A 25-year Investment License Agreement (ILA) between the national government and the tobacco industry signed in 2001
has been a major obstacle in increasing tobacco excise taxes. The ILA gave a five-year profit tax holiday (2002-2006) and limits the ad valorem excise tax rates
to 15%-30% (depending on the production costs declared by tobacco companies), which are much lower than the ceiling rate of 55% required under Lao PDR’s
Tax Law of 2005. Linked to this, tobacco companies have been declaring low production cost values for more than 10 years already, preventing the government
from collecting the appropriate tax revenues and promoting cigarette consumption with cheaper cigarette prices. After sufficient analysis, the government chosealternative methods to improve the tax structure and gain additional revenues in spite of the limitations of the ILA. To compensate for the losses due to the ILA,
the government issued decrees in 2010 to collect value-added tax (VAT, set at 10% of the product retail price) and an additional specific excise tax of LAK 100/
pack, in addition to the limited ad valorem excise rates stipulated in the ILA. A Sub-decree on financing a Tobacco Control Fund is currently pending at the Prime
Minister’s Office, which would collect a proposed 2% profit tax from tobacco companies. If approved, an estimated USD 150,000.00 can be collected that will
go to the Tobacco Control Fund. Dedicating tobacco tax revenues for public health purposes, which needs a collaborative effort among the Ministry of Health,
Ministry of Finance, and civil society, will support tobacco control and health promotion activities to prevent initiation of new smokers and save more lives fromtobacco-related diseases and is expected to save the government from further health-related economic losses.
1
Global Youth Tobacco Survey (GYTS) , Lao PDR, WHO, 2 Lao PDR Health Survey 2003., 3 Vang. C., Ross. H., Senchanthixay. M., Southammavong. T. (2009).
Tobacco-Related Socio-Economic Cost of Stroke, Lung Cancer and COPD in Laos;

124P-PL3-15 High-priced Smuggled Cigarettes: the Case of Vietnam
Minh T. NGUYEN1, Son T. DAO2, Nga Q. NGUYEN3
University of Illinois at Chicago1, Center for Economics and Community Development2, Massey University3
Background: Total tax currently makes up 42% of cigarette prices in Vietnam, which stands in the middle of the regional countries and well below 65%, thelevel recommended by the World Bank. Cigarette smuggling is one of main obstacles to raising cigarette excise tax since the last tax increase in 2008. The mainargument is that higher taxation will lead to higher prices of legal cigarette taxes and therefore their lower competitiveness compared to lower-priced smuggled
cigarettes. All previous data on cigarette smuggling in Vietnam came from the tobacco industry. Methods: Data used in this research were from the Survey on
Cigarette Consumption in 12 provinces of Vietnam, accounting for 32 percent of the country population, in 2012. This is the first survey on smuggled cigarettes
with no financial sources from the tobacco industry in Vietnam. Descriptive statistics analysis were carried out to examine the patterns of smuggled cigarette
consumption. The formula to estimate the excise tax rate that will equate the average prices of smuggled cigarettes and legal cigarettes was constructed basedon the current tax structure in Vietnam. Result: Smuggled cigarettes made up 20.78% of total market share of the 12 surveyed provinces. The average price ofsmuggled cigarettes was 0.74 USD, approximately 46% higher than the average price of legal cigarettes. The average number of sticks bought in the last purchaseby smuggled cigarette smokers (31.2) was 30% lower than that of legal cigarette smokers (44.8). Middle and higher income people made up higher percentages
in smuggled cigarette smokers than in legal cigarette smokers (67.96% vs. 56.65%). Among the 10 signals for identifying that the pack in the last purchase was
smuggled, “being more expensive than legal cigarettes” was the fourth top signal selected by smuggled cigarette smokers. Not a single person in the smuggled
cigarette smokers indicated that “being cheaper than legal cigarettes” was the reason he believed that his pack was smuggled.  Given that the average price ofsmuggled cigarettes was approximately 46% higher than that legal cigarettes, the excise tax rate can be raised from the current rate of 65% to 148% of the factory
price without leading to higher average price of legal cigarettes compared to the smuggled one.  Conclusion: The data consistently indicated that smuggled
cigarettes were considerably more expensive than legal cigarettes and were comsumed by higher income people. Doubling the current excise tax rate will notmake legal cigarette average price more expensive than that of smuggled cigarettes, therefore it will not likely to attract more cigarette smuggling into Vietnam.
Acknowledgement: This project received support from the NIH Fogarty International Center (Grant Number R01TW007924), awarded to Duke University's
Program on Global Health and Technology Access in collaboration with the Southeast Asian Tobacco Control Alliance and the American Cancer Society. The
content is solely the responsibility of the authors and does not necessarily.

P-PL3-16 Perverse Economics of Tobacco Trade in India
Pranay LAL
International Union Against Tuberculosis and Lung Disease
Background: Tobacco and tobacco products are extremely affordable and widely accessible to all in India. As in much of South Asia, the entire lifecycle oftobacco products is subsidised – with low minimum wages for workers, heavy subsidies on input materials, and tax waivers for manufacturers. Such incentives
keep production costs of tobacco products low, making them highly affordable to its users and profitable to its manufacturers. Tobacco lifecycle is promoted by
the Government with a stated intent of improving employment and livelihood opportunities in marginalised communities. However, its economic incentives areperverse as these policies permit tobacco manufacturers to extract a large and (currently) un-estimated price that violates human rights, keeps wages of workers,
degrades the environment, and limits options for better livelihoods of vulnerable communities. These factors driving the lifecycle of tobacco and facilitating
its production also limit the effectiveness of demand-side strategies to combat the prevalence of tobacco use. Increasing taxes, in particular, fails to induce any
perceptible changes on retail prices of tobacco products. As input and manufacturing costs are kept artificially low, even significant tax increases do not translate
into corresponding price increases and cuts to manufacturers’ profits are nil or negligible. At the same time, governments are often reluctant to increase taxes
drastically as it appears unethical to benefit from sin taxes.
Objective: To identify and measure the size of inherent subsidies in making tobacco products in India
Methods: Analysis of each step within the tobacco life cycle is considered and the subsidies involved are identified and measured.
Result: We argue that taxation will become more effective and efficient if corrections are made across the supply side of the product lifecycle to realise the fullcost of the product.

P-PL3-17 Cigarette Price and Retailer Survey in the Philippines
Irene Patricia N. REYES, Ralph Emerson P. DEGOLLACION, Nichola L. LIBORO
Health Justice Philippines
The objectives of the survey are:
1. To develop a sound methodology for gathering baseline data on cigarette prices and retailers, such as sari-sari stores and “jump boys”.
2. To determine price differences between the same cigarette brands in different areas in the Philippines.
3. To study the characteristics of retail establishments selling cigarettes and the types of incentives provided by tobacco companies.
The key findings are:
1. Marlboro (international brand) and Fortune (local brand) both produced and sold by Philip Morris Fortune Tobacco Corporation, Inc. (PMFTCI) are the two leading brands.
2. Cigarettes are sold per stick at 50 centavos to PhP5 (0.01 to 0.12 USD). Price per pack of 20 sticks ranges from PhP7 to PhP79 (0.17 to 1.88 USD).
3. Average price differences show significant variation in average price per stick of international brands according to area (rural and urban) and province (National Capital Region[NCR], Laguna, and Mindoro), while there is none for local brands. Average prices per pack of international brands vary only in terms of area but not by province, while local brands
differ significantly according to both area and province.
4. The local production of international brands coupled with tobacco companies’ strategy of offering for sale cigarettes in packs of 5s or 10s have made international brands more
affordable.
5. Retail margin for both international and local brands is higher in urban areas. Between international and local brands, retail margin is higher for international brands.
6. Tobacco companies take advantage of the allowed advertisement for point-of-sale establishments.
7. Tobacco companies also provide trade incentives in the form of free signboards, functional objects, gift rebates, trade and point-of-sale allowances, price incentives and volume
rebates.
The key recommendations are:
1. Conduct price survey in other areas to determine extent of differences.
2. Monitor the impact of PMFTCI monopoly on cigarette prices, retail, and consumption.
3. Push for comprehensive ban in tobacco advertising, promotions, and sponsorship, as well as prohibit repackaging into smaller packs.
4. Strictly implement the ban on sale to minors.
5. Investigate changes in tobacco companies’ supply chain and distribution networks and their impact on cigarette prices, retail, and consumption.

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P-PL4-01 Smoking Reduces Life Expectancy in Japanese the Same as Other Populations
Ritsu SAKATA1, Paul MCGALE2, Eric J. GRANT1, Kotaro OZASA1, Richard PETO2, Sarah C. DARBY2
Radiation Effects Research Foundation1, University of Oxford2
Results from previous studies have suggested that the effects of smoking on mortality among the Japanese are smaller than western countries. The reasons forthe smaller risk estimates have been unclear. We investigated the impact of smoking on mortality and life expectancy in a large Japanese cohort and believe wehave solved part of the paradox. We published the results in The British Medical Journal1).
The Life Span Study is a long-term (>60 years) prospective study of atomic bomb survivors. Smoking status was collected on multiple occasions via interviews
or mail surveys between 1963-92. A total of 67,973 subjects reported their smoking status at least once. The risk of smoking for all-cause mortality was analyzed
from one year after the first ascertainment of smoking status until 1 January 2008. Each time new smoking information was obtained via a subsequent survey,
the person was reclassified and contributed to the person-years at risk in the updated category one year later. Age-standardized death rates by sex, attained age,
calendar year and smoking status were calculated using Poisson regression.
The average length of follow-up in the study was 23 years. Fifty-four percent of subjects reported their smoking status more than once. Smokers born in later
decades tended to smoke more cigarettes per day than those born earlier, and started smoking at younger ages. Among smokers born during 1920-45 and whostarted smoking before age 20, the overall mortality was more than double that of never smokers in both sexes (rate ratios: males 2.21 [95% confidence interval
1.97 to 2.48], females 2.61 [1.98 to 3.44]) and life expectancy was reduced by about a decade (8 years for males, 10 years for females). The strengths of this study
include a considerably longer average follow-up period compared with previous major Japanese cohort studies of smoking, and smoking status was ascertained
more than once for many individuals. These strengths reduced misclassification errors and provided a fuller accounting of a person’s smoking history. Results
indicated that those who start smoking in early adult life and continue smoking lose about a decade of life. These findings are similar to risks observed in westerncountries and imply that smoking is not less dangerous among the Japanese as has been previously suggested. Other findings indicate that those who stopped
smoking before age 35 avoided all of the excess risk among continuing smokers, while those who stopped before age 45 avoided most.
1)
Sakata R, McGale P, Grant EJ, Ozasa K, Peto R, Darby SC. BMJ 2012:345(e7093)

P-PL4-02 FCTC COP5 Outcomes and Work towards a Successful COP6
Edgardo Ulysses DOROTHEOSEATCA Southeast Asia Initiative on Tobacco Tax, Southeast Asia Tobacco Control Alliance
In November 2012, the Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (FCTC) held its fifth session in Seoul, Republicof Korea. Each session of the COP sets the tone for global, as well as national, tobacco control for the years to come. Apart from adopting numerous important
decisions to strengthen the fight against tobacco epidemic, COP5 highlighted the need to secure a “whole of government” commitment for implementation of the
FCTC. The contributions of the civil society in supporting tobacco control efforts proved vital yet again.
However, COP5 outcomes will be only as strong as their follow-up. Governments need to implement newly adopted guidelines and guiding principles, fulfil
their treaty obligations such as reporting, and sustain their work on further treaty instruments. Civil society has an important role to play during this process – bysupporting the governments directly in their tobacco control efforts, serving as a watchdog to monitor whether countries comply with the FCTC provisions, orproviding input to FCTC’s inter-sessional work, such as participating at in FCTC working groups.
This presentation will provide an overview of the COP5 outcomes, paying attention to the key decisions adopted in 2012 and highlighting opportunities for civilsociety to engage in monitoring and strengthening tobacco control at country and global level.
In particular, the presentation will:● outline the content of the newly adopted guidelines and guiding principles that governments need to implement in their national tobacco control efforts relating
to taxation and product regulation (Article 6, Article 9 and 10)● describe ongoing work on treaty provisions and opportunities for governments and civil society to participate in the FCTC inter-sessional process – Article 6,
Article 9 and 10, Article 17 and 18, Article 19● review obligations under the Convention which all governments need to fulfill in the inter-sessional period – reporting, payment of contributions
The presentation will also provide information on additional topics expected to be discussed during COP6, which is expected to take place either in 2014 or 2015.

P-PL4-03 Empowering Health Workers to Become Change Agents to Support Rural Communities to Fight Tobacco
Deepak J. PATIL, Rajashree S. KADAM, Devika M. CHADHA
Salaam Bombay Foundation
Background and Objectives: In 2007-2008, Salaam Bombay Foundation (SBF) conducted need assessment in nine villages of Chandrapur district, Maharashtra,
which revealed 45% villagers used any form of tobacco and some bought them on credit with loans of up to USD 40-45. Assessment also revealed that villagers
looked upon health workers in their communities, referred to as ‘tai’, who are considered as elder sisters giving proper health advice. Since these workers are partof the community, they are uniquely positioned to disseminate tobacco control awareness within the community. Therefore, SBF strategized a tobacco control
program to be implemented by ‘tai’s’ in ten villages with objectives of intervening with schools, villages, local government authorities, and local NGO’s.
Methods: SBF conducted a four-day comprehensive training for 24 ‘tai’s’, who were briefed on various SBF run school programs, various aspects of Indian
Tobacco Control Law (COTPA 2003) and advocacy on ‘tobacco control’. Use of folk media to disseminate anti-tobacco messages was also introduced to them.
Culturally relevant ‘information, education and communication’ (IEC) materials such as flipcharts, information booklets, CDs and posters were also provided
to these workers. ‘Tai’s’ implemented the SBF tobacco control program in ten villages of Chandrapur district and conducted sessions on tobacco awarenessproviding motivation to quit to tobacco users through the medium of songs, rallies, drama, puppet shows and street plays. Program monitoring is done quarterly
by SBF and review meetings conducted with health workers, presidents of villages and village councilors. Feedback from villagers is also gathered.
Results: SBF addressed tobacco control issues among 15,324 inhabitants in 20 villages and 1,633 children in 11 schools through 24 trained health workers,
known as ‘tai’s’, who successfully conducted tobacco control sessions. Ignorant villagers especially village education committee members started showing keeninterest in tobacco eradication. President of a village council himself quit tobacco and got involved in making the village tobacco-free. Post program evaluation
after a year of implementation showed 90% villagers were aware of ill-effects of tobacco and were keeping tobacco away from their children.
Conclusion: Villagers were convinced by and confided in Tai’s as they belong to the community. Street plays, songs, drama, puppet shows were effective tospread tobacco control messages to rural people. SBF plans to expand this programme to 60 villages in Chandrapur district in the coming year, and conduct
trainings for health workers on new amendments and developments in tobacco control law and activities in India.

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P-PL4-04 Tobacco Smoking and Poverty in the Fertile Female Population
Andrea Z. FOGARASI-GRENCZER1, Ildikŏ RĂKŎCZI2, Kristie L. FOLEY3, Pĕter BALĂZS1
Semmelweis University1, University of Debrecen2, Davidson College3
Background: Women’s smoking in Hungary (33.9%) exceeds the European average (26.06%) and it is astonishingly high in the fertile female population(30.8%). Low socioeconomic status (SES) and the stress of poverty impose an additional burden on smoking women during the pregnancy and contribute to thehigh prevalence of low birth weight (8.4%) and preterm birth (9.0%) in this country.
Methods: Our research in the most underdeveloped region of Hungary, targeted smoking habits prior pregnancy of a population living under the poverty level(n=8,573) among women (n=12,176) who delivered live born babies between 2009-2011. Logistic regression at p<0.01 level was used to demonstrate the factors
contributing to smoking in this population.
Results: 8,573 women represent 70.5% of the whole sample. They were living under the poverty level and 54.2% were smoking (regularly/every day=43.2%,
occasionally 11.0%). The average age of smoking initiation was 16.5 years (SD=3.21) in the regularly smoking sample. 59.0% were living in extreme poverty.
Factors unfavourable for pre-pregnancy smoking: lowest (basic) education versus highest (OR=4.16, 95%CI=2.89-6.00), housing without amenities versus
partial amenities (OR=1.41, 95%CI=1.06-1.88), underweight versus normal weight (OR=1.34, 95%CI=1.13-1.58), living without versus with grandparents(OR=1.60, 95%CI=1.24-2.07) or a single room rented flat (OR=1.89, 95%CI=1.47-2.45). Employment versus being unemployed is also a negative factor(OR=1.45, 95%CI=1.20-1.76) as is a smoking versus non-smoking husband (OR=4.43, 95%CI=3.85-5.10). Being married is protective if compared with noncontractual cohabitation (OR 0.46 95%CI 0.28-0.75).
Conclusion: Prevention programs are needed to address the most at-risk, impoverished women prior to and during pregnancy. The programs should target not
only women, but also their partners and community-level determinants.
Key-words: poverty, fertility age, regular smoking

P-PL4-05 Looking at Policy Change at the Provincial Level in China
Xia WAN1, Frances STILLMAN2, Xiaochang ZHANG3, Mark SPIRES2, Zhen DAI1, Stephen TAMPLIN2, Jonathan M. SAMET4, Gonghuan YANG1,3
Peking Union Medical College1, Johns Hopkins University2, Chinese Centers for Disease Control and Prevention3, University of Southern California4
Objective: To compare progress toward implementation of five key tobacco control policies in seven Chinese provinces (Shanghai, Tianjin, Heilongjiang,
Henan, Guangdong, Zhejiang and Jiangxi) supported by Fogarty in 2001 to the overall national progress. The polices were based on MPOWER and included:
protection from second-hand smoke (SHS); offering help to quit; health warnings regarding tobacco use; enforcement of bans on tobacco advertising, promotion,and sponsorship (TAPS); and increasing tobacco taxes and prices.
Methods: The Global Adult Tobacco Survey questionnaire (GATS-China) provided national-level data. A modified version was used in the seven provinces;
2000 families were selected by 4-stage stratified cluster sampling and surveyed. The sample was stratified by age, gender and urban-rural status based on Chinese
census data from 2010. The survey contained 10 indictors to assess key policy areas.
Results: Provinces were located in the East, Northeast, South and the central areas of China, representing a broad range of the population. Two indicators(smokers attempting to quit with cessation aids and warnings about tobacco use) were better in the provinces than at the national level. Nationally, only 9.2% ofsmokers attempted to quit using cessation aids compared to rates ranging from 52.1% to 72.5% in the study provinces. Nationally, 59.8% of respondents noticed
information on the dangers of smoking while the rates in the provinces ranged from 64.7% to 92.1%. However, protection from SHS exposure was much lower
in a number of the provinces than the national level, and only Shanghai had lower levels. Heilongjiang, Jiangxi and Henan were found to have the highest levelsof SHS exposure at indoor working places (71.3%, 80.0%, and 75.1%, respectively) than nationally (63.3%). No differences were found concerning TAPS
comparing province and national levels. Expenditures for 100 packs of cigarettes as a percentage of 2009 per capita GDP were lower than the national averagein Tianjin, Shanghai and Guangdong.
Conclusions: China, by implementing the modified GATS at the provincial-level was able to determine how policy implementation was progressing in theselocations with Fogarty program intervention as compared to the nation as a whole. The findings show that provinces differ on their progress toward implementationand on some policy issues provinces are making progress while others are not. It is encouraging to find that use of cessation aids and warnings about the dangers
of tobacco are making progress in some of the provinces; however, much work is still needed on SHS protection.

P-PL4-06 Changing Tobacco Control Policy in Southeast Asia: The Power of a Regional Collaboration
Yen L. TAN, Bungon RITTHIPHAKDEE
Southeast Asia Tobacco Control AllianceThis paper highlights the power of national and regional partnerships in advancing tobacco control policy advocacy within Southeast Asiancountries. Emphasis isalso given to strategies used and successes of these regional efforts. The need to work and act collectively to curb the tobacco epidemic in Southeast Asia resulted
in the establishment of a regional anti-smoking movement, the Southeast Asia Tobacco Control Alliance (SEATCA), in 2001. SEATCA forms progressive andstrategic partnerships with various government and non-government organizations, universities, and the World Health Organization (WHO) in most ASEAN
countries to advance the full implementation of the Framework Convention on Tobacco Control (FCTC) across the region. SEATCA acts as a catalyst to initiate
and advance tobacco control policy. To enhance local capacity, partners are engaged in various focused activities such as regional and country consultations,
meetings, workshops, study visits and on-going capacity building. Advocacy, training, mentoring, fellowships, research and media monitoring are also part ofthe capacity building efforts. Stakeholders are empowered and encouraged to contribute ideas, take initiatives, articulate their challenges and work hand-in-handwith SEATCA to identify policy needs. Building awareness and knowledge on tobacco control among key-decision makers are crucial to obtain commitment
and understanding that will lead to policy reform.These relationships are dependent on building trust among and within partner countries, which in turn, helps
strengthen cooperative, sharing and responsive relationships. There is significant progress over the past five years in developing and implementing of stronger
tobacco control measures in most ASEAN countries. Recent examples include:• establishment of the Tobacco Control Fund (TCF) in Lao PDR in January2013, which imposes a 2% tax on tobacco industry profits besides a specificincreaseof 200 Lao Kip (LAK) per cigarette pack;• passage of tobacco control law and regulation in 2012 that requires pictorial health warnings to be printed on cigarette packages in Vietnam and Indonesia;• enactment of Sin Tax Law in the Philippines in December 2012; and• Cambodia’s ‘free-for-all tobacco-advertising paradise’ image ended with a subdecree to ban tobacco product advertising in February 2011
These positive changes are supported by the strong regional collaborations betweenASEAN country partners, reinforced by common goals, trust and the sharing
resources.

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P-PL4-07 The Economic Impacts of Tobacco vis-à-vis Rice Farming and Implications on Agricultural Development Planning: A
Case Study in the Philippines
Jennie Lyn C. REYESSoutheast Asia Tobacco Control Alliance
The study aims to examine the economic impacts of tobacco vis-à-vis rice farming and identify what its continued production entails for farming households
and local government units (LGU) in the Philippines. It will review related legislations, policies and programs to understand the legal framework that governs
agriculture in general, and tobacco farming in particular. In addition, the paper will also look into the contribution of the tobacco excise revenues (embodied in
Republic Act 7171) to see whether it benefits the tobacco farming communities as recipients, especially the farming households in Candon City, Ilocos Sur as
the case study.
This paper will compare the profitability of tobacco vis-à-vis rice by subjecting the household incomes derived from these crops to cost and returns analysis.
Furthermore, the study will also measure the household-level food security by using the subsistence level carrying capacity analysis. Finally, the study will
examine the trends in tobacco leaf production that seems to be in a relative decline characterized by decreasing productivity of farms where tobacco are planted;
the change in the land uses of these agricultural lands; and/ or the shifting of farmers from planting tobacco to other crops.
The paper will conclude whether tobacco farming as an agricultural activity has positive economic impacts. While it is not consumed for food, it is a contributor
to household income and employment generation; thus, the paper will explore whether income from tobacco farming can contribute in the attainment of household
food security, as an objective in agricultural development planning. In comparing the net income from farming rice and tobacco, the paper would establish if
tobacco-farming households are on the same footing as rice farmers in these terms, as the average cost of production in farming tobacco is significantly high. In
addition, the paper will also conclude whether Republic Act 7171 (tobacco excise fund allotted to tobacco farmers) has directly benefitted tobacco farmers andtheir communities, if at all; since one of its inherent weaknesses is its failure to include the tobacco farmers themselves in the actual management of the fund. RA
7171 also comes in direct conflict with Articles 17 and 18 of the FCTC, as well as provisions of Republic Act 9211 (Tobacco Control Act), that call for alternative
livelihood programs for tobacco farmers in compliance with these laws.

P-PL4-08 Coordinated Legal, Political and Media Advocacy to Ban Gutka (Smokeless Tobacco) in India
Vandana SHAH1, Pankaj CHATURVEDI2, Vijay Anand R. PALKONDA3, Sanjay SETH1, Jaspreet K. PAL1
Campaign for Tobacco Free Kids1, Tata Memorial Hospital2, Apollo Hospitals3
Background: India has one of the highest rates of smokeless tobacco use in the world. Among 275 million Indian adult tobacco users in India, 75% consume
smokeless tobacco products. One third of all males use smokeless tobacco products; khaini is the most commonly used form, followed by gutka and betel quidwith tobacco. Among female tobacco users, 91% use smokeless products; betel quid with tobacco is the most common, followed by gutka and khaini. The
epidemic rise of oral cancer cases in recent times as a result of gutka use across all socio-economic groups has become a cause of great concern to public healthofficials in the country. A Supreme Court decision banning the use of plastics in gutka packaging in December 2010 provided an opportunity for tobacco control
activists to develop a comprehensive strategy for banning gutka itself. On August 5th, 2011 central rules were finally issued under the Food Safety and Standards
Act(FSSA) banning the use of nicotine in food products. So by virtue of this notification under FSSA, gutka was banned by the central government. State andnational advocates began to use this rule to lobby states to pass state orders banning gutka and begin immediate implementation
Objectives and methods: A series of advocacy efforts were carefully planned to successfully get states to ban gutka. These included: 1) political advocacy withstate chief ministers using gutka victims through the Voices of Tobacco Victims(VOTV) campaigns; 2) The legislative assemblies in many states were sensitizedusing victims on the harms of gutka 3) Sustained media campaign including extensive electronic media coverage. 4) Defensive and offensive legal action in theSupreme Court and High Courts to get states to ban gutka and to defend ban orders from industry attack
Results: To date, 19 states and 4 union territories have passed ban orders and have begun to implement these bans. Implementation remains a challenge but
significant losses in gutka industry show that the bans have had an impact on sales. One major challenge is that industry is also marketing alternative products
which consumers are substituting for gutka. Industry has also pushed back in a significant way through media and behind the scenes lobbying but civil society’s
close coordination with government in this campaign has helped defend the bans till date.
Conclusions: Concerted legal, media and political advocacy can result in significant gains in regulation, including ban of harmful tobacco products like gutka.
Close coordination between civil society and central and state governments was key to this unprecedented victory. But significant challenges remain related toindustry push back, product substitution and illicit trade which will need to be addressed creatively.

P-PL4-09 Crop Substitution: A Case Study of Bangladesh
Shameem H. PATWARY
Dhaka International University, Supreme Court Bar Association, Humanist and Ethical Association of Bangladesh
I as Co-coordinator of Tobacco Control and research sell of DIU conducted a field research on crop substitution awareness. The Anti - Tobacco Act, 2006
prescribe that the Government will encourage for substitute crop production within 5 years. But since passing the Act, 2006 tobacco cultivation is increasing day
by day in particular the entire hill side is now under tobacco cultivation zone. The survey report shows that 80-90% farmers are not aware of impact of tobacco
or it’s cultivation, 80-90% farmers took advance loan for tobacco cultivation signed bond for 3-5 years for cultivating tobacco. The research paper was submitted
to different authority and we arranged a round table discussion where I presented the outcome of the research and suggested possible leeway’s to overcome thesituation. After the discussion we accumulate the opinions and submitted it to concern ministers for their kind perusal and also make it published to different
national Dailies.

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P-PL4-10 The Recognition of Smoke-Free Legislation: Attitudes of the Hotel Staffs Towards Non-Smoking Environments in Chiba
Masako TANAMURA1, Kazunori NAKAKUKI1, Yukio KATSUMI2
Healthcare Professionals Association against Tobacco in Chiba1, Smoke-Free kids2
Background: In 2002 the Japanese government introduced its first legislation, Promoting Health Acts, to prevent exposure to second-hand smoke in public areas.
In 2010, the Japan Ministry of Health, Labour and Welfare announced in detail its prevention efforts, which included a prohibition of smoking in hotel facilities.
However, most of hotels in Japan still permit smoking.
Methods: Questionnaires were mailed to 50 hotels in Chiba prefecture. 46 were returned completed, 3 were declined, and 1 was marked with no response. The
hotels that completed the questionnaires were classified into 4 categories according to districts as follows: Narita 12, Makuhari 6, Maihama 6, and others 22.
For each hotel, we analyzed the smoking environment at the hotel facilities, recognition degree of hotel representative regarding some regulations, and theimportance of non-smoking environments as rated by hotel customers. We totaled scores to evaluate and rank hotels on their strict obedience of smoking
legislation at their facilities.
Results: Hotels in Narita and Maihama scored higher than other districts on the ratio of non smoking rooms to total rooms.
Hotel staff's degree of recognition concerning the Promoting Health Acts and the FCTC (Framework Convention on Tobacco Control) stayed at 60% and 11%
respectively across all hotels investigated. Hotel staffs in Maihama were highest regarding the recognition of Promoting Health Acts. Regarding the needs ofhotel customers, many questionnaire participants wished for an increase in non-smoking rooms and for there not to be tobacco odor in guest rooms.
High ranked hotels we chose by our own evaluation were concentrated in Narita and Maihama. Moreover, foreign-financed hotels tend to be more highly ranked
hotels than Japanese financed hotels. There were only 3 hotels that prohibited smoking completely in bars.
Conclusion: There were regional variations in Chiba prefecture on the effort made to create non-smoking environments. Narita, near Tokyo International
Airport, used more by foreigners, and Maihama, near Tokyo Disney Land, used more by families, were the 2 districts with the highest ratio of non smoking
rooms. Many hotels from these districts were chosen as high ranked hotels. We must inform hotels about international and domestic regulations, especially FCTC
on account of many hotels in all districts of Chiba not being familiar with FCTC.

P-PL4-11

The Direction of Tobacco Countermeasure which was Showed in the Opinion Pool of the Citizens Investigated in
Matsuyama City in Japan

Kaori HIROHASHI1, Fumiko KAIDA1, Seiji FUJIOKA2, Yoshihiro TAKAISHI1
Hojo Hospital1, Akari Clinic2
Beginning: Since Japan ratified FTCT, seven years have passed, but tobacco countermeasure has made slow progress in Japan. Under this circumstances, weinvestigated recognition of FCTC and evaluation of tobacco control policy, in Matsuyama City , the local city, in Japan. In this time , we would like to express ouropinion about the results of the opinion pool of the citizens of Matsuyama City.  Method: We made self registrating inquiries to 44 assemblymen of Matsuyama, and 230 citizens of Matsuyama.  Results: Withdrawal proportion from the assemblymen of Matsuyama was 29.5%, and from the citizens was 89.1%. Only 5
assemblymen of Matsuyama and 27 citizens knew about FCTC, and a large majority concluded insufficient policy. Such as “prohibition of passive smoking at the
public space” or “driving forward smoking cessation therapy” were not enough to be mentioned as rather valid countermeasure such as the raise of the tobacco
price or penal regulations. Secondly , a large majority recognized about ill effect of smoking , and hope for the right information and education. There were
only 2 members of Matsuyama assembly having opinion of promoting FCTC. And even, there was an opinion that tobacco tax is precious source of revenue.
Consideration: Japanese government is reducing the cost of social security and driving forward the preventive medicine , the other hands , expecting therevenue from tobacco tax. We suppose there is a national politicalcontradiction on this point. This contradiction is leading to theKnown regulation matterobstacle that Japan government was not made international treaty
17.1%
Indication inclussion more than 30%
61.5%
FCTC well-known. That is why assemblymen of Matsuyama had low
21.5%
Prohibition of labelling such as "mild" "light"etc
38.5%
interest in tobacco countermeasure. There is not a little already known
13.7%
Prohibition of sponsorship of the tobacco…
38.5%
regulations of FCTC if not knowing FCTC and it is easy to providing
42.4%
Protection
fromtobaccosmoke
for penal regulations. It is necessary to be taken measures reflected
76.9%
25.9%
public opinion about information dispatch or education. The result
Adequecy of the tobacco price
Citizens
23.1%
was suggested that common knowledge of right information greatly
47.8%
Assemblymen
Promote treatment for tobacco dependence
46.2%
influenced the development of tobacco control policies.

P-PL4-12 Indonesian Compliance to Framework Convention on Tobaco Control (FCTC)
Soewarta KOSEN
National Institute of Health Research & Development
The FCTC was developed in response to the globalization of tobacco epidemic. On 21 May 2003, the 56th World Health Assembly unanimously adopted theFCTC. Indonesian delegates contributed actively in the working group during preparation. However, due to internal politics and tobacco industry pressures,Indonesia becomes the only country in Asia-Pacific that did not sign the Convention. The government regulation No. 19/2003 on tobacco control was issued to
be in-line with FCTC. Similarities of the regulation with FCTC include protection from exposure to tobacco smoke in working places, public places and public
transport. The regulation still permits tobacco advertisement and promotion in electronic media, printed media and billboard. The latest Indonesian Health Law(No. 36/2009), considered tobacco as an addictive substance. Since then, efforts to propose more strict regulation for tobacco products based on the newest
health law were initiated, faced strong opposition; not only from the tobacco industry, but also from tobacco and clove farmers, tobacco workers and retailers.
Following the enactment of the latest Health Law on 2009, the Ministry of Health, NGOs and academic communities proposed the new regulation to replace theRegulation No. 19/2003. The new Regulation is directed to protect health of the community and regulates: cigarettes and other tobacco products, responsibilityof the Central and Local Government to supervise access to tobacco and to diversify tobacco products, to implement smoke free area, to apply pictorial warning,
to protect minors, to encourage community participation on tobacco control and to do monitoring and supervision of the regulation. It took almost three years
before the government finally agreed to the new regulation last December 2012. At present the Ministry of Health initiated efforts to do accession to FCTC, tomake Indonesia bocomes the party of FCTC. Hopefully this effort will be successful in the near future.

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P-PL4-13 Can India Facilitate Diversification from Tobacco Dependent Employment?
Research Findings from an All India Study on Tobacco Growers, Bidi Rollers and Tendu Leaf Pluckers
Nayanatara S. NAYAK, Dattatreya R. REVANKAR, Narayan N. BILLAVA
Centre for Multi Disciplinary Development Research
Background: India is a member of FCTC and is committed to bring down consumption and production of tobacco in the country through array of measures.
In addition to demand side measures there is also a need for supply side intervention. But, such kind of intervention requires data on socio-economic status of
population engaged in related activities, economic feasibility of alternative livelihoods, availability of infrastructure, identification of factors that could enable
shifting, and about willingness of the targeted population to shift from tobacco related activities. Unless such information is made available it is difficult todevelop a comprehensive rehabilitative plan. Articles 17 and 18 of FCTC lay stress on existing data gap and call the tobacco growing countries to update theirinformation base on such matters.
Objective: The objective of the study is to identify feasible alternative crops and livelihoods to tobacco cultivation and related activities and develop acomprehensive intervention strategy to facilitate decision making in this regard.
Research questions:i) Are there any economically viable alternatives to tobacco crop, bidi rolling and tendu leaf plucking in India in the background of different socio-economic,
cultural and agro-climatic factors?
ii) Whether the stakeholders are willing to shift from tobacco dependent vocations and if so what are the challenges in facilitating shifting.
Methods: The required database for the study is gathered from 12 states having large population of tobacco growers, bidi rollers and tendu leaf pluckers in
different agro climatic regions of the country. The data is collected through two main sources. The quantitative information is gathered from primary surveyof 6000 farm households, 1000 bidi rolling and 500 tendu leaf collecting households selected by following a five stage stratified sampling method. And thequalitative information is gathered from one to one discussion meetings with association of stakeholders in different states and involves consultation withdifferent government departments.
Note: The data is being analysed and the findings will be available to public in August, 2013. We expect the proposed study to guide supply side tobacco control
strategy in India in the coming years.
Acknowledgement: Study sponsored by IDRC, Canada

P-PL4-14 TFAJ, Tobacco-Free Advocacy Japan, its Agenda & Activity
Jun SONO, Masahiro KANEKO, Hajime I. SONO, Fumiro TAKEMOTO, Hiroko TODA, Shigeki TOYOTA, Hidekazu NAKAGAWA, Hiroshi MATSUOKA,
Yuji KUNIMI
Tobacco-Free Advocacy Japan
TFAJ, Tobacco-Free Advocacy Japan was founded on 2011 to promote tobacco-free environment in Japan on grass root basis by advocating to change the social
norm with regard to tobacco and was certified as a NPO corporate body on 2012.
According to the statics of Japan,130 to 200 thousand smokers die of tobacco related diseases, and 6,800 to several ten thousand non-smokers die of second-handsmoking, every year.
Tobacco is deeply related to almost all disease, premature death, violence, abuse, poverty and unhappiness. When we look squarely at these realities, the only
radical solution is but to eradicate tobacco and realize tobacco-free society. TFAJ declared this policy as an agenda on its Japanese HP. http://tobaccofree-adv.
main.jp/
In spite of the obligation as a party to enact comprehensive tobacco control law by 2010 and to implement FCTC faithfully, Japan has no tobacco control law yet
unfortunately, but some local ordinances, which are all misleading to designated smoking space instead of smoke-free environment in public places. JT, Japan
Tobacco, welcomes these local ordinances and allures air conditioning & carpentry industries to join this business chance.
We regret that these misleading local ordinances might cause further delay of making smoke-free environment indoors without exception, which is recommended
by WHO as the global standard.
The first scientific meeting of TFAJ was held in Kobe on September 2012 with 193 delegates. Dr. Jeffrey Wigand, the famous model of the movie “Insider” andan adviser to TFAJ, also joined the meeting, gave an impressive lecture, and inspired us. The second meeting will be held in Tokyo on September 2013.
TFAJ welcomes international advices and cooperation, please contact us to the following address.
tfaj-office@tobaccofree-adv.main.jp

P-PL4-15 Challenges to Tobacco Taxation Implementation in the Pacific
Matthew ALLEN2, Amelia DALLEY2, James RARICK1, Mina KASHIWABARA1, Ada MOADSIRI1World Health Organization1, Allen and Clarke Policy and Regulatory Specialists Ltd2
Despite tobacco prices being high relative to many other countries, tobacco use rates are quite high in the Pacific. In addition, although there are some promising
policy, legislation and taxation initiatives, a lack of regulation on the way tobacco products are allowed to be marketed and sold, and in some case a lack ofenforcement of existing regulations, is likely to be an underlying cause for high tobacco use rates in the Pacific.
Increasing taxation is recognised as being the most cost-effective way to encourage tobacco users to quit. However, Pacific Island countries face unique challenges
to implementing taxation and regulations targeted at tobacco. This paper focuses on the role that locally-grown tobacco products play in a government’s ability
to effectively implement tobacco taxes and tobacco control law.
Locally-grown or ‘non-manufactured’ tobacco is generally grown on small family plots with a large number of independent growers. Further, it is often soldthrough traditional means, avoiding fixed retail outlets and formal regulation processes. This means that significant resources are required to regulate the large
number of sellers and to capture sales data, for both the collection of taxes, and for the implementation of wider tobacco control regulations.
In some countries the cheaper sales price of locally-grown tobacco has already caused an increase in its use. As Pacific Island governments are encouraged toraise taxes on tobacco, it is likely that locally-grown products will undermine the positive impacts of tobacco taxation, unless they are effectively regulated.
The authors will present tobacco use prevalence in the Federated States of Micronesia, Fiji, Papua New Guinea, the Solomon Islands, Samoa and Tonga, looking
in particular, where data exists, at the use of locally-grown tobacco products. The paper will:・describe the scope of locally-grown tobacco products currently available in the countries and the extent to which these products fall outside of existing
regulatory measures on tobacco;・describe the current challenges governments face in terms of regulating these products; and・present the implications for future changes to regulatory measures which could prevent the proliferation of these products and thus bolster taxation and wider
tobacco control efforts.

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P-PL4-16 Strengthening Tobacco Advertising Promotion and Sponsorship Ban in Bangladesh
Arif SIKDER
Environment Council Bangladesh
Bangladesh is a South Asian country with 149,772,364 people in a 147570 square km area, where the average population density is about 964 inhabitants per
square kilometer (BBS, 2011). Approximately 43 percent of adults (age 15+) in Bangladesh use tobacco. Tobacco smoking/chewing adversely affects people’s
personal, social and economic life. In Bangladesh, more than 57,000 people die each year from tobacco-related diseases. About 1.2 million cases of illnesses are
attributed to tobacco (Global Adult Tobacco Study, 2009).
Environment Council Bangladesh (EC Bangladesh), a non-profit and non-political voluntary organization, has been working strengthening TAPS Ban througha project titled ‘Advocating for and supporting a comprehensive Tobacco Advertising, Promotion and Sponsorship ban in Bangladesh’ in association withCampaign for Tobacco Free Kids USA, since November 2012.
The major purpose of the project is to reduce direct and indirect tobacco advertising, promotion, and sponsorship (TAPS) by tobacco companies in Bangladesh
through advocating for FCTC compliant amendments to the current provision on TAPS, and in the implementing regulations to follow. The project also seeks
to develop a framework for effective implementation, and enforcement of the TAPS law through the engagement of relevant stakeholders, and mapping of theimplementation/enforcement process taking into consideration lessons learnt from the implementation of the 2005 law.
The existing tobacco control law in Bangladesh, enacted in 2005. Some improvement of that law in order to comply fully with the Framework Convention on
Tobacco Control (FCTC) has been amended, which is going to finalize by the Jatiya Sangsad (National Parliament). Simultaneously the tobacco industries havebeen trying to prevent further improvement in the law that creates a barrier on the promotional activities they are doing through the loopholes of the law. This
project advocates for policy improvement and ensure proper finalization of TAPS ban law through the engagement of relevant stakeholders.

P-PL4-17 Support for Quitting Smoking to Adolescents at a Pharmacy in Japan
Katsushi MURAYAMA
Murayama Pharmacy
She was caught lighting up in her high school and consulted a physician with the staff of a rehabilitation institution.
We were told by the partnering medical institution that she needed short-term medical attention by using OTC, because her treatment was not covered byinsurance. Since she was medically-supervised, we determined to give medicine to her.
She came to our dispensary after she was advised to quit smoking by her doctor. We also provided advice about the ill effects of smoking, in the form of questions
and answers. We also explained the medicinal effect, dose regimen and side effects of nicotine patch 20.
Five days later, she was prescribed a steroid external medicine for treatment of itching at the site of the patch application. At that point, she still had the desire
for smoking and felt a strong urge to smoke when she saw that other people were smoking.
Eight days later, we reduced the dose from nicotine patch 20 to 10 according to the order from her doctor, since it could lessen the cravings for a cigarette.
Thirteen days later, we were advised by her doctor to terminate medical treatment for her when she had used up all prescribed medication, because she had
become free of the desire for smoking.
I noticed her perceptions had changed a lot when she came to our pharmacy at the end of the treatment period. Also she had begun to carry out antismoking
activities in her school such as warning a teacher not to smoke.
This is such a case where we could lead a patient to quit smoking completely in a short time, in collaboration with school, rehabilitation institution, medical
provider and dispensing pharmacy.
While we had no idea how to deal with this case because we had never supported people underage to quit smoking before, we thought it would be best to contact
her as long as possible. Therefore, we advised her to stop at our pharmacy on her way to and from school to report her state of stopping smoking, even after
treatment was completed.
After that, she visited us several times until her graduation, and talked to us with a smile, stating, “I have not smoked a cigarette.”
She got a job at the supermarket in Ehime prefecture after graduating from high school.
We are presently checking if she has been stopping smoking.

P-PL4-18 Supporting Pacific Island Countries to Strengthen Their Resistance to Tobacco Industry Interference in Tobacco Control
Judith MCCOOL1, Jeanie MCKENZIE2, Mathew ALLEN3, Annabel LYMAN4
University of Auckland1, Secretariat of the Pacific Communities2, Allen and Clarke3, Framework Convention Alliance4
Background: Tobacco industry interference in tobacco control is a contributory factor for slow or delayed introduction of effective tobacco control policy
with Pacific Island Countries particularly those that are underequipped to respond due to limited resources for developing and enforcing policy and regulatory
frameworks.
Aims: i) To undertake a preliminary assessment of Pacific country experience of tobacco industry interference; ii) To develop a practical, directly relevant toolkit
to assist Pacific countries to effectively resist tobacco industry interference.
Results: The preliminary assessment of 11 of the 14 PICs signed to the WHO FCTC, identified a low awareness of tobacco industry interference (range from nointerference noted to up to six events).All countries were enthusiastic to learn more about the importance of Article 5.3 to strengthen tobacco control.
Two countries were selected on the basis of higher reported incidents of tobacco industry interference to receive specialist technical support. This support
included in-country meetings with government, tobacco control and civil society to develop a practical legislative response to tobacco industry interference.
Conclusion: This project assisted two countries to effectively resist tobacco industry interference through a systematic process (toolbox) including: assessing
knowledge, awareness and compliance with FCTC Article 5.3, developing guidance and identifying changes to administrative procedures/legislation and putting
into practice a ‘code of conduct’ or appropriate legislation.

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Secondhand Smoke Exposure in Cars and Homes is Associated with Susceptibility to Smoking in 14-15 Year Old
Children: Repeated National Survey Data

Benjamin HEALEY1, Richard EDWARDS1, Nick WILSON1, George THOMSON1, Janet HOEK1, Steve TAYLOR2
University of Otago1, AUT University2
Background: Exposure to secondhand smoke (SHS) causes adverse health outcomes for children and adolescents, and is implicated in increased risk of smoking
initiation. Important potential sources of children’s exposure to SHS include smoking in homes and in private cars
Aim: To explore the association between exposure to SHS in cars and homes and smoking susceptibility and smoking among 14-15 year old children.
Methods: We analysed data from a school-based national survey of New Zealand’s (NZ) Year 10 students from 2006-2012 (the ASH Year 10 surveys). Participants
were asked whether, in the past week, others had smoked around them in a car or van or in the home. Students who reported exposure on at least one day in thepast week were classified as exposed to SHS) We ran separate multivariate logistic regression analyses in which we classified all students as (i) current regular
smokers (smoking at least one cigarette per week) and non-regular smokers, and (ii) ever smokers (regular, occasional and ex-smokers) and never smokers; and(iii) in which all never smoking students were classified as susceptible and non-susceptible to smoking. All models were adjusted for age, sex, ethnicity, socioeconomic status, and parental, sibling and friend smoking.
Results: In 2011 a total of 26,645 students participated in the survey (response rate 45%). Exposure to SHS in cars (adjusted odds ratio [aOR] = 1.4) and inhomes (aOR = 1.5) were statistically significantly associated with susceptibility to smoking. Both variables were stronger risk factors than parental smoking
status (which was not significant), but less important than friend smoking status. Each of the surveys between 2006 and 2010 showed similar patterns. Other
analyses to be presented will explore the association of reported SHS exposure with regular smoking, ever smoking and ever smoking and susceptibility tosmoking combined.
Conclusions: Exposure to SHS in cars and homes are important potential risk factors for smoking initiation in children in NZ. Proposed approaches to reduce
this exposure include legislation to prohibit smoking in cars and mass media campaigns to encourage parents to make homes Smokefree. These findings suggestthat such policies not only protecting the health of children by minimising their exposure to SHS but may also reduce smoking initiation.
Acknowledgements: The authors thank the students who participated in all of the ASH New Zealand ‘Year 10’ surveys. The ASH surveys were funded by the
NZ Ministry of Health.

P-S1-02

The Impact of Designated Smoking Areas in Where Outdoor Smoking is Banned: The Case of Kobe City

Hiroshi YAMATO1, Nagisa MORI2, Rumi HORIE3, Loïc GARÇON2, Mihoko TANIGUCHI4, Francisco ARMADA2
University of Occupational and Environmental Health1, WHO2, The World Bank3, Kobe Pharmaceutical University4
In line with indoor smoking bans, an increasing number of cities worldwide have enacted regulations banning smoking in outdoor areas. Despite Japan beinga signatory to the Framework Convention of Tobacco Control (FCTC) since 2004, progress in translating the recommendation into national policy is limited.
Globally, many of the outdoor smoking bans cover outdoor dining areas, beaches, public parks, school and playgrounds etc. In Japan, streets adjacent to shopping
areas have been the focus of outdoor smoking bans. However, such bans remain very limited in scope and more importantly in their health aim. Most of the bansallow outdoor designated smoking areas (DSAs) within the no-smoking streets, thus explicitly limiting the protection from SHS. Although there is overwhelming
evidence about the failure on designated smoking rooms (DSRs) in preventing exposure to SHS, only few studies addressed DSAs. Our objective was to look at
the impact of DSAs on air quality in the areas of Kobe City where the municipal ordinance banning street smoking is in force as a part of a bigger study looking at
the compliance of the ordinance. Two different DSAs were selected, located near the main train station in Kobe. Air quality measurements were conducted twice
by using a SIDEPAKTM AM510 Personal Aerosol Monitor in August 2012. Three types of measurements were performed: 1) line-up measurement 2) verticaland horizontal measurement and 3) circle measurement. A total of four investigators lined up or made a circle with a monitor in hand and each measurement
lasted for 15 minutes. In the line-up measurement, the PM monitor at the closest point (4m away from the ashtray) detected more than 150 µm/m3 of PM2.5, andgradually flowed to the farthest point (25m away from the ashtray). In the vertical and horizontal measurement, high concentration of PM2.5 was detected at 4m,
18m, and 25m with approximately 80-110 µm/m3. In the circle measurement, a similar concentration of PM2.5 was detected at all of the testing points (meanconcentration of 94 µg/m³). The study indicates that DSAs are sources of SHS in zones where a street smoking ban is in force, since SHS spreads widely, bothvertically and horizontally. Street smoking bans that permit DSAs strongly limit the protection from SHS. Therefore, DSAs should be avoided to accomplish
effective protection against SHS in the area where street smoking bans are into effect.

P-S1-03

Smoke-free Policy Development Using Air Pollution Control as an Entry Point: A Case in Jakarta, Indonesia

Dollaris R. SUHADI1, Tara S. BAM2, Moch. Tauchid TJAKRA AMIDJAJA3, Mara O. SIREGAR3
Swisscontact Indonesia Foundation1, International Union Against Tuberculosis and Lung Disease2, Special Capital Region of Jakarta Province3
Objective: to examine how the provincial government of Jakarta developed its smoke-free environments policy from the air pollution control local ordinance,
further contributing to the national smoke-free policy formulation.
Methods: Interviews with key informants who were involved in advocacy, drafting, or adoption of air pollution control local ordinance and its subsequent
implementing regulations including amendments necessary to achieve 100% smoke-free environments were conducted. A diary, relevant documents and press
articles issued during a period from 2005 to present were investigated. Two public opinion polls were carried out in 2009 and 2011 to determine public perception
towards secondhand smoke. A secondhand smoke monitoring study was also conducted to support the arguments for smoke-free policy.
Results: Air Pollution Control local ordinance was passed in 2005. The ordinance also regulates indoor air pollution by restricting smoking in public places. An
environmental NGOs coalition, the provincial government, and environmental caucus in the parliament actively advocated the agenda. The No-smoking area
provision in air pollution control legislation came as a surprise to the tobacco industry. In 2009, the Jakarta government began to revisit its regulatory framework
following exposure to best practices in smoke-free policy. In 2010, an amendment to the regulation was discreetly made, backed up by the positive results ofpublic opinion polls and secondhand smoke monitoring study in 2009. The instrumental change was removal of indoor smoking rooms. Such policy formulation
was later on adopted by the national government. The Jakarta government survived two litigation cases following the enactment of the smoke-free regulation.
It continued to strengthen its policy by issuing an implementation decree in 2012, which provides comprehensive guidelines for an effective on-the-ground
implementation and enforcement.
Conclusions: Building public knowledge and belief in the extent of the risks of secondhand smoke is critical. Continued public support and mentoring during
policy development process can ensure that government takes action in a prompt manner and that the regulation will be enforceable. Enabled government
institutions, improved staff knowledge and local scientific evidence are also key to winning the litigation. Tobacco control issue can be addressed through anenvironmental protection agenda in the presence of strong leadership in the sector.

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How Bloomberg Grants Programme Prioritised and Accelerated FCTC/MPOWER Implementation in India?

Jugdeep S. RANA, Pranay G. LAL
International Union Against Tuberculosis and Lung Disease
Description: A global initiative to reduce tobacco use in low- and middle-income countries was launched in 2006 with funding support from Mr.Michael R.
Bloomberg. A competitively awarded grants program is an important part of the Initiative. The grants program supports projects to develop and deliver highimpact evidence-based tobacco control interventions based on MPOWER and FCTC. The grants program is managed by the International Union Against
Tuberculosis and Lung Disease (The Union) and the Campaign for Tobacco-Free Kids. Since the launch of the initiative, 27 grants have been awarded inIndia to both governments and civil society to effectively implement MPOWER priority interventions in tobacco control in India. 16 grants have already been
completed with 11 grants currently active in the country. This paper looks at the key progress and achievements under the initiative in India through the BI grants
programme.
Methodology: All 27 grants both completed and currently active were evaluated for their population outreach; measures achieved towards capacity building;documented successes from advocacy; MPOWER policy development and implementation; coalition and networks built; inter-sectoral involvement; policy
focussed strategic research and monitoring and prioritising tobacco control in the country.
Conclusion: The Bloomberg Grants programme has contributed significantly to prioritising tobacco control in India. Civil society, local government and the
National Tobacco Control Programme have benefited from the Initiative resulting in implementation of the MPOWER policy package including increasingprotection from second hand smoke to millions in the country, increasing awareness of the harmful effects of tobacco use through coordinated media campaigns
and health warnings on tobacco products and supporting development and implementation of FCTC in the country.
Target Audience: Health care professionals and stakeholders in Tobacco, Cancer and NCD prevention and control programmes
Key Words: Bloomberg Initiative, tobacco control, grants programme, MPOWER policy

P-S1-05

The Pattern of Rural Retailer’s Behavioral Concerning Cigarette Sale to Minors in The Lower Northern Thailand

Chakgarphan PHETPHOOM, Piyarat NIMPITAKPONG, Narongsak NOOSORN
Naresuan University
Corresponding author: Chakgarphan Phetphoom email: pumanatural@hotmail.com
Thailand has more than 570,000 tobacco retailers. This is the most accessible cigarette source of young smokers. The objective of this qualitative study was
to investigate the pattern of retailer’s behavior toward the sale of tobacco to minors in a community in the lower northern Thailand. The key informants wereobtained from 11 merchants whom were experienced with sold tobacco to minors and lived in a rural community. Data collected using in-depth interviews andnon-participation observations. Interview transcripts were analyzed, and the result revealed as following.
Although, all 11 tobacco retailers have perceptions about the law banning the sale tobacco to minors as well (Age less than 18 years old), they still sell cigarette
to young people. Every day, minors whose regular customers will buy cigarettes about 1-5 times per store. Most of them specific bought the individual menthol
cigarettes (approximately 1-3 cigarettes per time). During the time of the most cigarette distribution for minor is after school until the early hours (17:00 pm. to
20:00 pm). The pattern of rural retailer’s behavioral concerning tobacco sale to minor is divided into 3 types: young people who are strangers, young people wholive in the community and new customer and young people who live in the community and old customer.
Therefore, retailer’s behavior toward the sale of cigarettes to minor is still the challenging issue. This finding can be used to improve the tobacco control policyin Thailand regarding the timing of the sale of cigarettes which impacts directly to limit youth accessibility to tobacco.
Keywords: patterns of retailer’s behavior, tobacco sale behavior, timing of the sale of cigarettes

P-S1-06

Barriers for Local Governments in Japan to Control Tobacco: The Example of Hyogo

Keiko YAMADA1,2, Nagisa MORI1, Mina KASHIWABARA1, Rumi HORIE3, Hiroshi YAMATO4, Sakiko YASUDA5, Francisco ARMADA1, Loïc GARÇON1
WHO1, Hyogo Prefectural Government2, The World Bank3, University of Occupational and Environmental Health4, Kyoto University5
Since Japan has not fully implemented the WHO FCTC, smoking in public places is still widely permitted. As has been observed in other countries, subnational
initiatives have aimed at tobacco control in Japan. Kanagawa adopted a regulation in 2009 that partially restricts smoking in public areas; Hyogo is only thesecond prefecture out of a total of 47 in Japan to pass an ordinance to prevent exposure to second-hand smoke (SHS) in 2012. Through the analysis of the Hyogo
initiative, we identify key elements that both facilitate and interfere with tobacco control at local and national levels in Japan.
The study employed an explanatory case study approach. We documented and analysed the process of adoption of the local legislation, with an emphasis on
the proceedings of a committee appointed to prepare a policy proposal. Meeting minutes and other grey literature such as government records were collected andanalysed; an opportunistic website search, and input from two members of the committee complemented the information.
In 2010, a letter from the Minister of Health, Labour and Welfare encouraged prefectures and municipalities to implement measures to prevent exposure to SHS,
although it recognized “smoking separation” as a valid measure. Partly in response to this, and following a common process for local legislation, the governmentof Hyogo constituted a committee to solicit external input on a legislation to prevent SHS exposure. The committee included representatives from several sectors
and met nine times during 2010-2011. The tobacco companies were given an opportunity to participate in the committee meetings as guest speakers. Although
the committee agreed on the need to protect people from SHS, the scope of the regulation was a common source of dispute. Allowing designated smoking rooms(DSRs), and dividing public spaces into different levels of regulation were the most contested issues. Finally some agreement was reached towards a progressive
yet partial regulation. Nevertheless, the regulation which passed the assembly was weaker than the committee proposal and included wide exemptions especiallyfor hospitality business establishments, in contravention of the WHO FCTC. The analysis of the Hyogo initiative shed light on three factors that challenge
tobacco control at the local level in Japan. First, the Japanese government facilitates provisions that include DSRs. Second, the tobacco industry is allowed toactively interfere with the policy making process. Last, advocacy by civil society for a stronger regulation is weaker than that observed in other country contexts.

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People's Initiatives in Making Smoke Free Public Places: Case Study of Banke & Ilam Districts of Nepal

Shanta L. MULMI
Resource Centre for Primary Health Care
Purpose: To present how civil society and government can collectively make a change through collective efforts.
Method and Materials:
Banke district is an example of the efforts made by district police office to make smoke free public places. The office in cooperation with Health Rights andTobacco Control District Network have initiated massive campaign in the district and arrested more than one thousand smokers who were released after strong
warning. Smoke free campaign also conducted for 4500 petty shops, 214 hotels, 188 mobile shops, 79 betel leaf (Pan) shops, 50 tea stalls and 30 schools in thelast 8 months. The legal provision of Smoke Free public places has strictly implemented. A special "Mobile Police Squad" with motor cycle are being used to
do immediate action.
This District Police Office has shown to the other district that if there is a political will and determination, the resource is not a problem. These efforts are widely
acclaimed not only by Nepalese Media but also from Indian Media. (Newspaper clippings & Photographs will be presented.
The Ilam district, which is close to Darjeeling of India has been trying to make the city as "Smoke Free". Smoking is not allowed even in the street, you cannot
light the cigarette in any shop where you buy. Encouraged with this the city is also now free from Polythene Bag. Green City Strategic Plan has been developedby the Municipality. Sign board of "Tobacco Free Zone" in residential area is in progress.
Result : Police in Banke and Municipality in Ilam District have shown that "Smoke Free Public Place is possible if collective action with NGO like Health Rights& Tobacco Control District Network is undertaken.
Conclusion : To replicate these efforts in other districts of Nepal.

P-S1-08

En Route to the Enactment of Smoke-free Legislation in Kyoto

Narito KURIOKA1, Yuji YASUDA1, Masako SHIGETA1, Takashi DOI1, Atsuko AOKI1, Yoko KINOSHITA1, Yoshitsugu TANAKA1, Sumiko KURIOKA2
Kyoto Association for Tobacco Control1, University of Occupational and Environmental Health2
Aim: We will describe recent efforts to enact smoke-free legislation in Kyoto.
Action and Results: Kyoto Association for Tobacco Control (KATC) began calling for the enactment of smoke-free legislation in Kyoto after the establishmentof such legislation in Kanagawa in March 2009. At that time we were invited to join the local governmental committee on secondhand smoke.
Subsequently, in December 2009, KATC coordinated with local Medical, Dental, Pharmaceutical, Nurses, and Hospital Associations and requested the Governorof Kyoto Prefecture develop smoke-free legislation. In February 2010 our committee also urged to the Governor to prepare the legislation with all due speed.
We began outreach efforts to influential lawmakers in the prefectural and municipal assemblies, and in August 2010 we hosted an educational forum called "TheZero Secondhand Smoke in Kyoto Project" which many assembly members attended.
Furthermore, we also began a petition drive in support of the legislative effort. In six months we collected over 35,000 signatures and received 600 messages of
support from all over the world via the internet.
Armed with our collection of signatures, we approached lawmakers for their endorsement, which at last led to an official request for the Governor’s administration
to draft a proposal for legislation, a key step in the formal introduction of such legislation into the assembly. Though he agreed to propose legislation restricting
secondhand smoke, to date the administration has only arrived at a charter of non-binding goals.
Meanwhile we are conducting a related campaign to collect restaurants' signatures to call for the enactment of this legislation.
In May 2012, a Tobacco-Free Symposium was held under the joint sponsorship of medical groups, the local government, and KATC. The success of thesymposium reinforced our firm belief that the power of Kyoto citizens and of the scientific community will lead to a tobacco-free future for Kyoto.
Conclusion: We are hoping to collaborate with other groups to enact smoke-free legislation in various districts in Japan and to achieve our vision of national
smoke-free legislation in the near future. We believe promoting evidence-based tobacco-free environmental policy will save the lives of many Japanese people,
and especially save our future, Japanese children.

P-S1-09

The Quality of Tobacco Free Zone Regulation in Three Provinces with Special Autonomy Status in Indonesia

Susy K. SEBAYANG1,2, Rizanna ROSEMARY2,3, Wulan A. SEBASTIAN4, JUANITA5
SUMMIT Institute of Development1, International Centre for Aceh and Indian Ocean Studies2, University of Syiah Kuala3, University of Sydney4, University of
Sumatera Utara5
BACKGROUND: Approximately 35% of Indonesian smokes, with smoking prevalence of 66% among men. The national government of Indonesia recently
launched a new tobbaco regulation that forces local governments of districts or cities to make local government regulation (Perda) on Tobacco Free Zone (TFZ)
where smoking, producing, selling, advertising and/or promoting tobacco products are prohibited. Prior to this regulation, 11% of districts/cities in Indonesia
have made attempts to protect their people from tobacco harms by establishing some forms of regulation on TFZ. Identifying common pitfalls in the current
regulations will help local governments and tobacco control advocates revise and guide the process of creating TFZ regulations in nearly 500 districts/cities
in Indonesia. METHOD: We selected legal products on TFZ in three provinces:Nangroe Aceh Darussalam (NAD), Jakarta and Yogyakarta, which havespecial autonomy status that allows more experience in creating and implementing autonomous regulation compared to other provinces. We compare available
regulations with the standard Perda proposed by Indonesian Tobacco Control Steering Committee (TCSC). These provinces do not have Perda specific for TFZ.
Therefore, Perda on air polution control and lower level regulations on TFZ were assessed. These included Perda on air polution control and Governor’s decree
on TFZ for Jakarta, Governor’s instruction on TFZ and Mayor of Banda Aceh’s decree on TFZ for Aceh and Perda on air polution control, Governor’s decree
on TFZ, Regent of Gunungkidul’s and Sleman’s decree on TFZ for Yogyakarta. RESULTS: Among major discrepancies found were (1)Jakarta and Yogyakarta
control the act of smoking only instead of prohibiting smoking, production, promotion and advertisement in TFZ as mandated by national regulation and TCSC
standard; (2)Jakarta assigns outdoor smoking zone, while Yogyakarta allows indoor smoking zone except in Sleman;(3)Penalties and sanctions are very week,
ranging from reprimand to administrative sanction. No fines were applied;(4)Individual violators are not held responsible in all provinces and only in Jakarta
responsibilities of TFZ managers are better detailed. We assigned scores to key components above and other components including number of regulations,
implementation details and assignment of monitoring bodies. Among the three provinces, Jakarta scored the best with 70% due to it’s detailed assignment ofresponsibility and monitoring bodies and NAD was last with 37%. CONCLUSION: Current local government regulations in autonomous provinces are lagging
from gold standard and tobacco control advocates need to focus on the above components to ensure stronger regulation in other district/cities.

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P-S1-10“Kyoto-based Tobacco-Free Caravan” Collaborated with Organizations, Universities, and Local Governments -Part2-

Takashi DOI1,2,5, Masako SHIGETA1,2,3, Daisuke MATSUI1,3, Isao WATANABE1,3, Narito KURIOKA1,2, Yoshitsugu TANAKA1,2, Atsuko AOKI1,
Yasufumi OOKITA4
Kyoto Association for Tobacco Control1, Kyoto Medical Association2, Kyoto Prefectural University of Medicine3, Kyoto City Board of Education4, Doi Internal
Medicine Clinic5[Objective]
A community-based approach is important and effective for tobacco control; however there have been few systematic movements in Japan. Our organization(Kyoto Association for Tobacco Control: KATC) has been working with local governments, universities and organizations such as Kyoto Medical Association,
Kyoto Dental Association, Kyoto Pharmaceutical Association and Kyoto Nurses Association to foster a program in public schools. We will evaluate theeffectiveness of the ”Tobacco-Free Caravan” program following the previous meeting, reflecting on the process of its development[Subjects and Methods]
We review the process of how the program spread. The program includes a lecture and workshops. The lecture consists of five parts; the damage to body, nicotine
dependence, how to quit, passive smoking and the social background of tobacco. Throughout keyword is " Don't be duped ". During the workshops, a quiz was
performed. Items in the workshops are chemical models, disease models, foreign tobacco-packs and posters. Students perform the role play to answer "I do notsmoke, because…". They draw the illustrations and create a piece of humorous poem
[Results]
In 2001, KATC and a community health center launched the program at two schools. The number of participating schools increased to nine by 2006, asuniversities collaborated to allow their students to participate in the program. In 2007, the Kyoto Medical Association (KMA) started to provide funds for the
program and we implemented the program smoothly at 19 schools. The programs were appreciated by teachers and students. Currently the Kyoto City Board of
Education commenced support and 56 junior high schools implement the program, and KMA supported the other 27 high schools[Conclusions]“Tobacco-Free caravan in Kyoto” has been progressing steadily as cooperative activity.

P-S1-11

Health Impact Assessment of the "Smoke-free Policy" in Gwangmyeong City

Mee-Kyung SUH1, Seoung-ryul KIM2
Korea Institute for Health and Social Affairs1, Suncheonhyung University2This research by the Korea Institute for Health and Social Affairs is an health impact assessment of the 2011 “smoke-free area” policy of Gwangmyeong City.
Constructing the “smoke-free” environment for all citizens is now a collective endeavor joined by the national government, local governments at all levels,and communities and citizens themselves. Gwangmyeong City has decided to prioritize the “smoke-free” policy in its commitment to the promotion of healthy
environments and life styles. In this regard, the city purports to pursue the “smoke-free’ policy in a most systematic and scientific way by employing the healthimpact assessment (HIA) procedure. The Korea Institute for Health and Social Affairs has been asked to analyze the basic conditions for the HIA procedure in
the context of Gwangmyeong City and prepare the specific measures for implementing it. The assessment procedure consists of (1) the preparation of the projectplan and the preliminary meeting, (2) the composing of the project steering committee, (3) screening – that is, the health impact assessment (HIA) of the “smokefree area” policy, (4) scoping – that is, the determining of the HIA procedures and methods in terms of (a) analysis of the basic data of Gwangmyeong City,(b) analysis of secondary data, (c) survey of residents, and (d) workshop with concerned experts and interested parties. The HIA-based policy suggestions will
include: (a) total prohibition of smoking in the Gwangmyeong City Hall complex, (b) smoke-free monitoring and regulation of public buildings and facilities (c)smoke-free monitoring and regulation of restaurants, (c) smoke-free monitoring and regulation of bus stops and terminals, and (d) preparation of the long-termroad map of the smoke-free policy of Gwangmyeong City. It is expected that the “smoke-free” initiative of Gwangmyeong City will not only benefit the city’s
residents and visitors in terms of smoke-free life, but also set a path-breaking standard to be followed by other localities, thereby benefiting the entire nation.

P-S1-12Current State and Future Prospect of FCTC in Taiwan

Sea- Wain YAUJohn Tung Foundation
Taiwan has implemented a new policy that ban smoking in most indoor public places and workplaces. The policy also required 35% health warning to display
on cigarette packaging, prohibition on tobacco advertising promotion as well.
However, compare to other countries, we still need to amend our policy, especially the smoking rate is still high, which is 8 % in junior high school and 15 % insenior high school. In order to protect citizens’ health, reduce tobacco consumption, and prevent youth smoking. The John Tung Foundation combined with other
215 Non-Governmental Organizations to press government to amend tobacco control policy. Nevertheless, the amendment suspended because of the election in
Taiwan at January, 2012.
The John Tung Foundation plans to invite Taiwan International Medical Alliance, Homemakers United Foundation, Consumers’ foundation, and Formosa Cancer
Foundation, Taiwan Medical Alliance for the Control of Tobacco to set up new goals that improve the tobacco control policy for 2013.
We present 4 major goals:
1. Government should prohibit smoking in all public places, and penalize owners who do not follow the policy.
2. Health warnings on cigarette packaging should increase to 80%, and implement plain packaging.
3. Government should prohibit all tobacco advertising promotion and raise penalty once tobacco companies break the policy.
4. Government should increase tobacco tax for NT 30 dollars and abolish tax-free tobacco.
Meanwhile, we should invite more NGO that support tobacco control policy and expose tobacco companies’ lies and advertise negative impact of smoking on
health instead of against them directly.

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How NGOs Confront Tobacco Industry and Press Government to Effectively Enforce the Tobacco Hazards Prevention Act

Sea- Wain YAU, Ted T. L. CHEN, Ching-Li LINJohn Tung Foundation
John Tung Foundation (hereinafter referred to as JTF), the very first non-profit tobacco control organization across the Chinese-speaking world, has been devoted
tremendous efforts on policy advocating, media promotion, tobacco control education, smoking cessation and international cooperation. JTF had organized morethan 200 non-governmental organizations to advocate the much-needed amendments of the Tobacco Hazards Prevention Act, endeavored to establish a “100%smoke-free indoor public places and workplaces”.
With 30-year experience in tobacco control, JTF has developed 6 marketing strategies: (1) inviting celebrities to speak up for the organization or events, andpersuade the mass media provide free air time; (2) establishing international connections and conducting exchanges on the tobacco control knowledge andexperience; (3) seeking supports from private enterprise, government authorities and academia for promoting tobacco control policies; (4) collecting and thelatest world tobacco control information; (5) establishing and maintaining the official website (http://www.e-quit.org) and hosting Quit & Win Campaign; and(6) providing access for general public to file complaints on second-hand smoke or other violations on tobacco control regulation.
As a non-governmental organization, it may be safe to say that JTF has been working successfully on tobacco control issues through various marketing strategies
for almost 30 years. One of JTF's major goals at the present stage is to closely corporate with countries involved in Asia Pacific Association for the Control ofTobacco and Cross Strait Tobacco Control Conference to jointly fight against tobacco hazards.

P-S1-14

Awareness and Support of 100% Smoke Free Indoor Area in Jakarta

Abdillah AHSAN, Ayke S. KITING, Nurhadi WIYONO
University of Indonesia
BackgroundThe government of Jakarta has initiative to control cigarette consumption by issuing local regulation no. 2/2005. It regulates air pollution and spesifically statessmoking prohibition in several public areas but still have a dedicated smoking room. To support 100% Smoke Free Jakarta, Governor Decree no 75/2005 wasrevised with Governor Decree no. 88/2010. The essential changes in the new Governor Decree is that special smoking area in closed public area is abolished.
Objective
To measure knowledge, attitude, behavior and support from public on 100% smoke free area regulation in Jakarta.
MethodData was collected using face-to-face interview in the 7 public areas and the total respondent interviewed was 840 people in the 210 location visited around
Jakarta.
ResultAlmost all respondent said that they are not comfortable being in a room with full of cigarette smoke (94%), even smokers themselves (90%) felt inconvenient.
91 percent respondent agree that smoking in-door should be prohibit, even smoker said that it is not allowable (85%). Less than half (47%) of respondent iswilling to report violation of no smoking area to the competent autorithies. Only 39% smokers respondents are ready to report the violence of regulation, while
non smokers have 54% and ex-smokers have 45%. Though smoking has been ban in restaurant, 89% respondent said that they will visit restaurant that prohibits
its customers to smoke inside. Even 82% smokers respondents also admit that they are going to visit the restaurants.

P-S3-01

Periodontal Disease, Education and Training of Dental Professionals, and Tobacco Control

Takashi HANIOKA
Fukuoka Dental College
Background and aim. Dental professionals have not fully embraced opportunities for tobacco intervention. The aim of my presentation is to suggest new strategy
to enhance smoking cessation intervention based on the novel findings regarding biological plausibility for the smoking-associated periodontal disease under
the universal health insurance system in Japan.
Methods. My presentation consists of four elements: First, I outlined my research career. Second, we reviewed literatures regarding tobacco interventions bydental professionals. Third, I conducted another review of recent studies regarding oral microbiology. Finally, we surveyed dentists and dental patients to clarify
the possibility of our strategy.
Results. A new strategy for dental tobacco intervention could be remembered by outlining my researches for; the effects of smoking on periodontal
microcirculation, effects of second-hand smoke on gingival melanin pigmentation in children and early childhood caries, epidemiology regarding smoking
and dental caries, periodontal disease, and tooth loss, interventions regarding motivating and helping dental patients to quit smoking, and smoking behavior
and attitudes towards smoking cessation intervention of dental students and dentists. The literature review regarding progression of the global dental tobacco
interventions in the United States and the European countries including the United Kingdom identified significant barriers such as lack of reimbursement andtraining for implementation to dental practice and dissemination and undergraduate education. Another review of studies regarding the effects of smoking
cessation on oral biofilms and those of tobacco extracts on virulence factor of periodontal pathogens would break the ice to enforce dental tobacco intervention in
Japan. The studies that was conducted in dental clinics revealed that tobacco intervention for prevention of progression of dental disease and improvement of theeffects of dental treatments that have potential coverage of the universal health insurance system in Japan were strongly supported by dentists while intervention
services for prevention of oral diseases was strongly supported by dental patients.
Conclusion. Dental tobacco intervention based on the effects on dental treatments would be promising strategy that reinforces those for oral and overall healthin Japan.

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P-S3-02

The Study of Oral Lesion Screening and Smoking Habit among Thais

Piyada PRASERTSOM1, Nontinee TANGCHAROENDEE1, Siripen ARUNPRAPHAN2, Waranun BUAJEEB3
Bureau of Public Health1, Thai Dentist against Tobacco Project2, Mahidol University3
Background: Oral cancer is one of life threatening disease. Most of oral cancers patients are detected at the late stage. For years that the 5 years survival rateof oral cancer has not been improved. Smoking habits is known as a significant factors not only lung cancer but also oral cancer. The early detection of oral
precancerous lesion is the most effective strategy to prevent oral cancer and increase a 5-year survival rate. This study was performed to assess the incidence oforal lesion, smoking habit and related factors.
Methods: The study project conducted in 12 provinces during 2010 – 2011. Interviewing form was used to interview patients aged 18 years old and over who
received health services at the Dental department. The purpose of this interview was to find a risk patient group on those who smoked, drank alcohol, ate betel
nut or had family history of cancer. After finding a risk patient group, dentists provided them a lesion screening and also advised them to avoid risk behaviors of
the oral cancer. If the screening detected the oral cancer lesions, patients would be transferred for further treatment and monitoring.
Results: Data was collected from 8,861 patients. 46% was male and 54% was female. The age average was 53 years old 25.6% was smoker. The mean smoking
period was 20 years. There was 7.3% of patient reported that they smoked immediately when waked up. 18% was alcohol drunker and 7.9% chewing betel nut.
Oral lesions were found in 504 patients (5.7%). 67 out of oral lesion patients(13.3%) had precancerous lesion. Smoking, alcohol drinking, betel nut chewing
and family history were significant associated with oral lesion occurrence. (p<0.05) When compare oral lesion rate between smoker and non-smoker. We foundthat the prevalence of oral lesion in smokers was 2.3 times higher than non-smokers.(9.5% in smokers and 4.4% in non-smokers; OR = 2.3 95% CI= 1.92,2.77)
Conclusion :Campaigns should be performed to make a trend, encourage a risk group to have knowledge and to receive service of oral tissue screening, andadvice for cigarette cessation as well as public quitting smoking places.

P-S3-03

Comparison of the Cases of Oral Cancer and Potentially Malignant Disorders (Erythroplakia and Leukoplakia)
Reported in 2009 and after Launching an Oral Lesion Screening Program in Thailand in 2011

Nontinee TANGCHAROENDEE1, Piyada PRASERTSOM1, Sompid KINTARAK2, Kanokporn BHALANG3, Wikul WISALSETH1
Department of Health Ministry of Public Health1, Songkhlanakarin University2, Faculty of Dentistry, Chulalongkorn University3
The early detection of oral cancer can increase a patient's 5-year survival rate. All dentists can detect potentially premalignant or precancerous lesions during
routine dental examinations without special tests. Based on this, the Thaidentistagainsttobacco group, comprising the Bureau of Dental Health, Ministry of Public
Health, Thai Health Promotion Foundation, and the Dental Association of Thailand, launched a potentially premalignant disorder oral screening program bydentists in 2011 at the general and community hospitals in the 76 provinces in Thailand. The objective of this program was to encourage dentists to perform oral
lesion screening on their patients, especially in groups at high risk for oral cancer; individuals with a habit of smoking, alcohol drinking, betel nut chewing orwith a familial history of cancer. This screening program provided training courses for dentists in some provinces and supported all provinces with packages oforal cancer screening handbooks, handbooks on how to help patients stop smoking using the 3A/5A technique, self-oral cancer screening posters and leaflets. The
data from the Ministry of Public Health’s International Classification of Disease 10Th Edition (ICD-10) indicated that in 2009, prior to the program, 1,369 casesof oral cancer,77 cases of leukoplakia (one case identified as tobacco associated leukoplakia ) and 3 cases of erythroplakia were reported from the general andcommunity hospitals in all 76 provinces. In 2011, after starting the program, 1089 cases of oral cancer, 928 cases of leukoplakia (12 cases identified as tobacco
associated leukoplakia) and 59 cases of erythroplakia were reported. Thus, Dentists in general and community hospitals detected significantly more cases ofleukoplakia and erythroplakia after the program. Encouraging dentists to examine the oral cavity and search for precancerous lesions and help their patients tostop smoking should help patients in groups at risk for oral cancer and identify patients with early stage oral cancer.

P-S3-04

Chemical Evaluation of 3 Different Electronic Cigarette Cartridges and Assessment of Knowledge, Attitude and PracticeRegarding E-Cigarette amongst its users in Pune City, India

Sushil A. PHANSOPKAR, Arishka DEVADIGA, Sahana HEGDE-SHETIYA, Simpy MAHULI, Amit MAHULI, Deepti AGARWAL
Dr. D. Y. Patil Dental College and Hospital

INTRODUCTION: An electronic cigarette (e-cigarette) is commonly used as an alternative for the smoked tobacco and is being promoted as a nicotine
replacement therapy (NRT) by the companies. There are no regulations regarding the manufacturing and sale of e-cigarettes and also the chemical composition
is not known. Hence there is a need to know the contents and the harmful effects if any of them and hence to conclude whether or not to promote the use of
e-cigarettes as a NRT. OBJECTIVES: 1) Chemical analysis of 3 different e-cigarette cartridges for detection of nicotine, glycerol, di-ethylene glycol. 2)
Assessment of knowledge, attitude and practice regarding e-cigarette amongst its users in Pune city. MATERIAL AND METHODS: Three e-cigarettes: Sample(A) – locally marketed unbranded e-cigarette (nicotine free), sample (B) - Indian branded e-cigarette (nicotine free) sample (C) – western branded e-cigarette(nicotine) were analysed using GAS CHROMATOGRAPHY AND MASS SPECTROMETRY TEST. A 6 month KAP Study also was conducted amongst
e-cigarette users in Pune city using a 23 item close-ended questionnaire. Snow-ball (networking) sampling was used. RESULTS: The GC-MS TEST showedpresence of nicotine in local e-cigarette sample (A) and the branded e-cigarette sample (B) which are marketed as nicotine-free. Also traces of compounds likepyridines, butanone and decanoic acid were found. The KAP study showed that overall knowledge was good amongst the e-cigarette user in Pune city and theattitude and practice which they showed towards e-cigarette was contradicting. CONCLUSION: The chemical analysis of the brands A & B showed presenceof nicotine when they are marketed as nicotine free products while the sample C followed product specification as being nicotine containing e-cigarettes. Morethan half of the e-cigarette users knew about the ill-effects of nicotine and all of them were willing to quit smoking and join a tobacco cessation programme but
similar attitude was not reflected towards use of e-cigarettes as half of them did not want to quit e-cigarette smoking nor did they want it to be banned in India.

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P-S3-05

Smoking Cessation Environment 2012, According to the 4 Fields of Dentistry in Japan

Kazunori. NAKAKUKI, Shuichi TSUBURA, Jun KITAGAWA, Kazumasa ABE, Toshio SAITOH
Nakakuki Dental Clinic
Objectives: SKMK is a study group in order to enlighten smoking cessation for fields of dentistry in Japan. We investigate actual conditions of the smoking
cessation environment with annual questionnaires against some dental parties. In this presentation, we announced the surveillance data about 4 fields of dentistryin 2012.
Subject and Methods: The data collection was performed by mailing to an official spokesman or official secretariats of from group A to group D. Group A was
Japanese 29 dental colleges, group B was 72 dental in Japan, group C was 47 dental associations of each prefecture, group D was Japanese 50 companies for
dentistry, respectively. Each questions were about no smoking areas as follows; (1) all sites of area, (2) meeting or assembly room, (3) lobby or waiting room,(4) dining or coffee space.
Results; The results of from group A to group D showed as follows, (1) A: 11(37%), B: 36(87.8%), C: 16(33%), D: 9(23.0%), (2) A: 29(100%), B: 36(87.8%),
C: 44(92%), D: 37 ( 94.8%), (3) A: 29(100%), B: 30(73.2%), C: 37(77%), D: 16(57.1%), (4) A: 28(96%), B: 31(75.6%), C: 33(69%), D: 22(73.3%).
Conclusions: The smoking cessation environment of group A was the most progressive in the 4 fields of Japan. However, there were not any groups thatsmoking cessation was done in the site of all area. Further questionnaire study is needed, and we wish to contribute to the improvement in smoking cessation of
all Japanese dentistry.

P-S4-01

The Smoke Risk for Ischemic and Hemorrhage Stroke Mortality

Chi-Pang WEN, Shiuan Bei WU, Min-Kuang TSAI
National Health Research Institutes, China Medical University Hospital
Background and objectives: In Asia, the major cause of cardiovascular disease is stroke while
in Western countries is heart disease. Smoking, beyond hypertension, is the most important causeof stroke; however, most smokers are unaware of the risks. The present study was conducted todetermine the attributable mortality risk of ischemic and hemorrhage stroke among smokers.
Methods: A cohort, consisting of 412,387 adults, aged 20 and older, participating in medical
screening program run by a private firm since 1996, was followed up to 2008. A total of 836 deaths
were identified as stroke, with 488 as ischemic stroke, and 348 as hemorrhage stroke. Participants
went through a series of medical tests on blood, urine, body measurements, functional tests, andquestionnaire. COX proportionate hazards model was used to calculate the mortality risks. Results:
The smoking rate in the cohort was 23.3% (96,159 subjects). Controlling gender, age, education,
systolic blood pressure, fasting blood glucose, BMI, cholesterol, drinking, and physical inactivity,
the hazard ratios for stroke mortality was 1.73 in current smokers (95% confidence interval 1.422.11), with 73% increased risk than non-smokers. Among smokers, the attributable mortality riskof smoke was 49.2% for ischemic stroke, and 30.0% for hemorrhage stroke. Compare to current
smokers, ex-smokers had significant lower risk for CVD (HR=0.77) and stroke (HR=0.80).
Conclusions:Smokers who died from stroke had 40% attributable mortality risk due to smoking.
Among different stroke types, the ischemic stroke death was more related to smoking thanhemorrhage stroke. The study found that quitting smoking significantly reduced stoke mortality
risk. We strongly suggest smokers to quit.Keywords:Smoking, Stroke, Cohort study

Table. Hazard ratios for selected causes of mortality, by smoking status
Total cohort

Non-smoker

Ex-smoker

Current Smoker

Attributable(N=412,387)(N=290,801)(N=25,427)(N=96,159)

deaths(smoking)ICD-9

All causes

001-999 10455 5524 1.00 1461

1.35 (1.26 ,1.44) * 3470 1.62 (1.53,1.71) *

1,327

CVD

390-459 2023

1065 1.00

317

1.34 (1.15 ,1.55) *641

1.61 (1.42,1.83) *

244

38.0

410-414 570

273

1.00

105

1.56 (1.19 ,2.05) *192

1.71 (1.35,2.17) *

80

41.4

CHD

Total Deaths HR Deaths HR

95%CI

Deaths HR

95%CI

430-438 836

442

1.00

124

1.35 (1.07 ,1.71) *270

1.73 (1.42,2.11) *

114

42.2

Ischemic

430-432 488

234

1.00

87

1.60 (1.19 ,2.15) *167

1.97 (1.52,2.55) *82

49.2

Hemorrhage

433-438 348

208

1.00

37

0.98 (0.65 ,1.47)

103

1.43 (1.05,1.95) *31

30.0

Hazard ratios were adjusted by sex, age, education, systolic blood pressure, glucose, BMI, cholesterol, drinking, and physical activit

Figure. Ex-smokers had lower hazard ratios for cardiovascular mortality than current smokers.
(Reference group: current smokers)

CHD: Chronic heart disease
CVD: Cardiovascular disease

Smoking Cessation Reduces Oxidative Stress Measured by Salivary Oxidation-reduction Potentials.

Koji HASEGAWA1, Noa NAGAOKA1, Hiromichi WADA1, Sayaka SHIMADA1, Maki KOMIYAMA1, Yuko IIDA1, Hajime YAMAKAGE1,
Noriko ASAHARA1, Akira SHIMATSU1, Yuko TAKAHASHI2
Kyoto Medical Center, National Hospital Organization1, Nara Women's University2
Background: Oxidative stress by cigarette smoking is associated with ruptures of atherosclerotic plaques and leads to the onset of cardiovascular events, such as
myocardial infarction and cerebral infarction. As measurement of salivary oxidation-reduction potentials is very simple, it might be useful as a tool to evaluate
the extent of oxidative stress in smokers.
Purpose: We measured the salivary oxidation-reduction potentials in smokers and evaluated time course changes in the oxidation-reduction potentials bysmoking cessation.
Method: Ten smoking patients (male/female: 7/3, 53.3 years old of average age), who consulted our smoking cessation clinics and achieved smoking cessation
were recruited. In these patients, we evaluated time course changes of the oxidation-reduction potential values during anti-smoking medical treatment. The
salivary oxidation-reduction potential values were measured by using the oxidation-reduction measuring device called "ARA ! GENKI." We judged +40 mV or
more of the potential values as an oxidative state, and less than +40 mV as a reductive state.
Result: At the time of the first consultation to our smoking cessation clinic, the potential value of these smokers exhibited the strong oxidization of +73.1±29.4
mV. By smoking abstinence, the oxidation-reduction potential value demonstrated the significant trend of decreases (p= 0.003). Especially at the time of the 5th
consultation (after 12 weeks of anti-smoking medical treatment starts), the potential value was +35.9±24.8 mV, showing a relatively reductive state. The potential
value at the time of the 5th consultation was significantly (p< 0.05) lower compared with the values at the first and 3rd consultations.
Conclusion: It was demonstrated, by measurement of the salivary oxidation-reduction potentials, that smokers are in a strong oxidative state and that such anoxidation is reduced by smoking cessation. Thus, measurement of salivary oxidation-reduction potentials might be simple and useful tool to evaluate the extent
of oxidative stress by smoking.

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38.2

StrokeHazard ratio

P-S4-02%

OutcomeP-S4-03

Impact of the Passive Smoking on Vasospastic Angina –Analysis of the Urinary Cotinine-

Kazuhisa NISHIMURA1, Takayuki NAGAI1, Ogimoto AKIYOSHI1, Jitsuo HIGAKI1, Haruhiko HIGASHI2
Ehime University graduate school of medicine1, Kitaishikai Hospital2【Background】Cardiac disease was the second cause of death in japan, and consisted of 30% of all death. Coronary artery disease (CAD) is one of the mostimportant diseases in cardiac disease. Active cigarette smoking is a well established major preventable risk factor for coronary artery disease. Previous studies
have reported that passive smoking is also associated with increased risk of CAD by measurement of serum cotinine concentration. Prevalence of vasospastic
angina（VSA）was more frequent in Japan compared with the foreign countries. However, the relationship between urinary cotinine value, which indicatespassive exposure to tobacco smoke, and VSA had not been reported.
【Aim】We aimed to evaluate the relationship between urinary cotinine and VSA.
【Method】We enrolled 22 patients（mean age: 61±10yrs, 9 men）who were suspected of VSA. All patients were performed coronary angiogram andacetylcholine (ACh) provocation test. Urinary cotinine was measured at administration.
【Results】Fourteen patients of all were diagnosis as VSA by ACh provocation test. Urinary cotinine value was significantly higher in smoker compared with
non-smoker (1.16±0.23 vs 0.063±0.17 ng/ml, P < 0.0001). However, urinary cotinine value in VSA group was not significantly higher compared with non-VSA
group (0.281±0.48 vs 0.235±0.47 ng/ml). We divided into 2 groups according to the urinary cotinine value: H group (n=7); urinary cotinine value > 0.11 ng/ml,
L group (n=15); it ≤ 0.11 ng/ml. Prevalence of VSA was 80% in H group, and 50% in L group.
【Conclusion】Passive smoking may induce vasospastic angina from the view points of urinary cotinine. Passive smoking prohibition has not been drawn up
yet in Japan. We should prohibit passive smoking in Japanese public place for public health, in especially prevention for cardiac disease.

P-S4-04

The Effect of Smoking on Body Weight and Glucose Metabolism

Chisato MURATA
Tokyo Saiseikai Central Hospital<Purpose> The typical images we have of smokers are those of skinny patients, and oftentimes the cessation of smoking leads to an increase in weight, a signal
some people would take as the onset of diabetes and other disturbing changes. It is considered that the risk of smoking outweighs that of weight increase due tosmoking cessation, and we tried to study this.
<Subjects> To examine the effects of smoking and the cessation of smoking on body weight, glucose metabolism and liver function, we selected non-diabetic
patients. With diabetic patients the periodic treatments of the disease may affect their lifestyles including diet or exercises, which would lead to the change
in body weight or other factors related to metabolism. We selected 913 male without diabetes or impaired glucose tolerance from the group having a periodic
checkups.
<Result> Compared to the group of non-smokers(N-S) (n=469) in the group of smokers and ex-smokers(S)(n=444), Body Mass Index(N-S 23.7±2.9, S 23.9±2.7,
p=0.83), HOMA-R(N-S 1.70±1.1, S 1.76±1.0, p=0.39) were relatively high, although they were not significant. Waist/Hip ratio(N-S 0.90±0.48, S 0.91±0.05,
p=0.04), γ-GTP(IU/l)(N-S 49.1±46.6, S 60.4±104.2, p=0.03), triglyceride(mg/dl) (N-S 119.4±80.7, S 135.9±89.9, p=0.0036), uric acid(mg/dl) (N-S 6.0±1.2, S
6.2±1.2, p=0.017) were significantly high. HbA1c(%)(5.6±0.3,5.6±0.3,p=0.22) were similar in both groups.
<Conclusions> It is suggested that smoking cessation neither worsens nor improves body weight, insulin resistance, or blood glucose level.
On the other hand, according to the value of γ-GTP, triglyceride, uric acid, and Waist/Hip ratio, smoking habit is expected to be related to eating habits such as
high calorie intake or drinking habits. Lifestyles do not change greatly after smoking cessation which may cause weight gain.
The limit of this research is due to the insufficient information about ex-smokers. It lacks the data such as Brinkman index, duration from quitting, how thepatients quitted smoking, and other details of medical interventions.
Further investigation is also needed to analyze if a close intervention in lifestyle improves metabolic factors or not.

P-S4-05

Outcomes of a Smoking Cessation Clinic in Cardiology Services, Vancouver, Canada

Chizimuzo T. C. OKOLI1, Milan KHARA2
University of Kentucky1, Vancouver General Hospital2
BACKGROUND: Adults who have experienced cardiac events have a high burden of smoking and are likely to continue post cardiac event. Research in thispopulation suggests that smoking cessation services offered to this population can reduce the re-occurrence of cardiac events by assisting patients in cessation.
However, few cardiology clinics offer smoking cessation services and few cardiologists refer patients to such services. The Smoking Cessation Clinic (SCC)
provides evidence-based smoking cessation treatment within Cardiology services in Vancouver General Hospital in Vancouver, Canada. The aim of this study
was to evaluate the SCC program in terms of its program engagement and smoking cessation/reduction outcomes.
METHODS: This observational study employed a retrospective chart review to examine pilot smoking cessation/reduction outcomes among individuals (N=115)
attending the SCC within a two-year period. Within the two-year pilot review period, 81.7% (94/115) of participants engaged in the treatment. Informationcollected from participant charts included demographics (gender, age, source of income) tobacco use (number of cigarettes smoked per day, age at smoking
initiation) and cessation (evidence based modalities used to quit in the past, length of time abstinent at last quit attempt) history, motivation to quit (confidence
and importance of quitting, stage of change), nicotine dependence (based on Fagerstrom Test for Nicotine Dependence), psychiatric and medical comorbidities,
and expired carbon monoxide level (exp CO level). The main outcome was smoking cessation based on 7-day point prevalence of abstinence (verified by CO <8 parts per million and/or self-report) at the end of treatment. A secondary aim was smoking reduction defined as reduction to 50% or less of baseline cigarette
consumption.
RESULTS: Among engagers, 36.2% (34/94) successfully achieved smoking cessation and 41.7% (25/60) of those who did not achieve cessation reduced theirconsumption. Significant multivariate predictors of program engagement included older age (OR=1.0, 95% CI=1.0-1.1), greater importance of quitting (OR=1.3,
95% CI=1.1-1.6), and a greater number of medical comorbidities (OR=1.7, 95% CI=1.0-3.0). Significant multivariate predictors of successfully achieving
cessation included being male (OR=3, 95% CI=1.0-13.6) and spending a longer duration (in weeks) in the program (OR=1.1, 95% CI=.71.0-1.1).
CONCLUSIONS: Despite the inherent limitations of this retrospective analysis, the modest smoking cessation and reduction outcomes from this pilot study
suggest that providing individualized, evidence-based tobacco treatment services is well received by patients in cardiology services. Such smoking cessationinterventions can aid in reducing the high burden of tobacco use and related disease among individuals with cardiac co-morbidities.

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P-S4-06

Heavy Metals, Toxic and Antioxidant Trace Elements in Tobacco Smoking

Duangkamol VIROONUDOMPHOL1, Lerson SUWANTON2, Umaporn PINYOSIRIKUL2, Siranee SATSUE2, Talabporn HARNROONGROJ2National Institute of Metrology1, Mahidol University2
Smoking is not only associated with decreased concentrations of several antioxidant vitamins and trace elements but also increased morbidity and mortality riskof diseases. Those due to heavy metal, other toxic and antioxidant trace elements in tobacco smoke are not sufficiently emphasized. Tobacco smoking influences
the concentrations of several elements in some organs. We sought to determine the relationship between the known effects of some trace elements and otherbiochemically important elements (Cd, Cr, Cu, Hg, Pb, Se and Zn) which are linked with smoking. Cigarette smoking may be a substantial source of intake ofthese hazardous elements not only to the smokers but also, through passive smoking, to nonsmokers. Studies were carried out on 150 smokers (50 industrial
cigarette smokers, 50 passive smokers and 50 local tobacco smokers) compared with 50 nonsmoking controls. Levels of whole blood lead (Pb) and cadmium(Cd) were significantly higher in smokers than in controls. Whereas chromium (Cr), selenium (Se), and zinc (Zn) levels were significantly lower among smokers
than controls. No significant differences of mercury (Hg) and Cupper (Cu) were found between both groups. For dietary intake assessment, smokers consumed
significantly less energy from carbohydrate, fat compared to controls, while energy derived from protein did not differ between groups. Moreover, smokers
consumed less dietary fiber and vitamins compared with controls. Increasing whole blood toxic trace elements in healthy smokers may be explained by low
antioxidant trace elements and vitamins that lead to develop oxidative stress and diseases and increased turnover or breakdown of vitamins and micronutrients.
Therefore public health should not only aim for smoking cessation, but also concern about diet in terms of vitamin and trace element content.
KEY WORDS: smoking; heavy metal; toxic and antioxidant trace elements

P-S4-07

Improvement of Blood Mobility at One Year after Smoking Cessation

Sayaka SHIMADA, Koji HASEGAWA, Hiromichi WADA, Sachiko TERASHIMA, Noriko ASAHARA, Hajime YAMAKAGE, Maki KOMIYAMA,
Masaru AKAO, Akira SHIMATSU, Yuko TAKAHASHI
Sapporo Social Insurance General Hospital
Background, Blood fluidity reflects the blood viscosity and the state of microthrombus formation. Decrease in blood fluidity leads to cardiovascular events, suchas myocardial and cerebral infarction. While poor blood fluidity in smoking patients generally improves at 3 months after smoking cessation, the fluidity gets
worse in patients who gain excessive weight after the cessation.
Purpose, We examined blood mobility at one year after smoking cessation in selected patients whose blood mobility got worse at 3 months after smoking
abstinence.
Method, We selected 21 patients (men 15, female 6) who achieved smoking abstinence, and whose blood fluidity got worse at 3 months after the start of smoking
cessation therapy. Blood fluidity was evaluated by measuring the blood passage time (BPT) in 100μL of blood using mobility measuring device MCFAN HR300.
Result, In these selected patients, we measured BPT at 1 year after the start of the smoking cessation therapy. We performed multiple comparisons of BPTs andfound that BPT significantly (p<0.01) decreases at 1 year compared with 3 months (before, 61.3 seconds, and 3 months, 74.0 seconds, and 1 year, 52.1 seconds).
Conclusion, In patients whose blood fluidity get worse at 3 months after smoking cessation, such worsening is eliminated at 1 year after the cessation. Further
studies are necessary regarding what kind of factors are participating in the improvement of blood mobility at one year after smoking cessation.

P-S4-08

The Difference of Total Cholesterol between Male Tobacco Smokers and Male Tobacco Non-smokers 20-60 Years Old in
Salemba during Year 2009-2010

Atikah I. FATYA
Universitas Indonesia
Smoking may be an aetiology of some diseases, such as cardiovascular diseases (CVD), cancer, respiratory diseases, pregnancy disorders, ulcus pepticum,
osteoporosis, and many others. Several researches confirmed that smoking may disturb the metabolism of fat, including total cholesterol concentration.
Eventhough the exact mechanism is still not fully known, it may be caused by nicotine. This research was designed to know the difference of total cholesterol
between two groups, male tobacco smokers and male non-smokers 20 – 60 years old in Salemba during 2009 – 2010. The data of 34 male smokers and 34
male non-smokers with consecutive sampling was taken from questionnaires and total cholesterol check by finger prick test. It was found that the averagevalue of non-smokers group’s total cholesterol was 187.1 (95% CI 176.21;198.15) mg/dL, while the average value of tobacco smokers group’s total cholesterol
concentration was 196.1 (95% CI 183.83;208.23) mg/dL. Therefore, there was no meaningful difference between tobacco smokers’ and non-smokers’ totalcholesterol concentration (p=0.1276). This result was different from previous researches, may be caused by the use of low-nicotine tobacco. Moreover, there
are several external variables which can contribute to the level of total cholesterol of a subject, such as diet, lifestyle, drugs, and types of cigarettes filter. Thus,
it is recommended to make a further research about the relationship between smoking tobacco and the level of total cholesterol, low-density lipoprotein (LDL)cholesterol, and high-density lipoprotein (HDL) cholesterol.
Keywords: Cigarette tobacco, total cholesterol, nicotine.

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P-S4-09

Exposure to Secondhand Smoke among Employed Male Japanese Coronary Heart Disease Patients and the Control of
Smoking in Their Workplaces

Yoko MATSUNAMI, Midori FURUSE
Yamagata University
Aim: In Japan, an increasing number of people past middle age with coronary heart disease are returning to work after treatment as percutaneous coronary
intervention technology progresses. To prevent recurrence of coronary heart disease, it is essential for employees to avoid not only smoking but to be protectedfrom secondhand tobacco smoke. There is thus a need to ban smoking in workplaces. However, many Japanese workplaces are likely to permit smoking for theforeseeable future. This survey was designed to obtain information on exposure to secondhand smoke among employed coronary heart disease patients.
Method: We conducted a survey in the form of a self-administered questionnaire for patients with coronary heart disease who had been re-hospitalized at
Yamagata Prefectural Central Hospital for cardiac catheterization from June 2009 to September 2010. Eighty-three male patients, both in and out of employment,
responded. This study was implemented with the approval of the Ethics Committee of Yamagata University School of Medicine and Yamagata Prefectural
Central Hospital.
Results: Patients averaged 61.5 ± 9.8 years old; 43 patients (51.8%) had a full-time job, and 31 (37.3%) were self-employed or engaged in agriculture. Seven
patients (8.4%) had never smoked; 23 (27.7%) had been ex-smokers before being diagnosed, 45 (54.2%) were new ex-smokers who gave up after being
diagnosed, and 8 (9.6%) had remained smokers. Only 25 patients (30.1%) had avoided exposure to secondhand smoke. The workplaces of 17 patients (20.5%)
had imposed a total ban on smoking in closed environments, those of 16 (19.3%) had designated smoking rooms, those of 17 (20.5%) had designated smoking
areas, and 30 (36.1%) workplaces had no plans to limit smoking.
A comparison between smokers and new ex-smokers showed that a high 62.2% of the latter had returned to full-time work, and that a very high 88.9% of thelatter had had a history of myocardial infarction. No statistically significant differences were seen between type of smoking control at workplaces.
Conclusion: Both the patients’ awareness of the danger of second-hand smoke and the preventive measures taken by workplaces are insufficient. Patients witha history of coronary heart disease are particularly vulnerable to smoking and secondhand smoke. It is thus important to promote a total ban on smoking insidepublic spaces and workplaces to protect all patients who return to work.

P-S4-10The Relationship of Smoking Dependence with Blood Pressure, Physical Activity and Body Fatness among Healthy Male
Smokers

Zulhusni SUHAIMI, Zuikefli SANIP, Hamid JAN MOHAMED, Hamy MOHAMED YUSOFF
Universiti Sains Malaysia
Introduction: Cigarette smoking has been reported to cause acute blood pressure elevation and its synergistic effect with sedentary lifestyle contributes tothe development of chronic diseases especially cardiovascular disease. However, it is important to assess the association between chronic smoking with bloodpressure, physical activity and body fatness parameters mainly to understand the long term effect of smoking on health.
Objective: To determine the relationship of smoking dependence with blood pressure and body fatness among healthy male smokers.
Methodology: This cross sectional study was conducted in Universiti Sains Malaysia, Health Campus, Kelantan. Hundred and seven subjects were recruited
randomly among 20-50 years male smokers. Eligible participants were asked to fill up the Fagerstrom Test for Nicotine Dependence (FTND) Questionnaire
which evaluates level of smoking dependency and International Physical Activity Questionnaire (IPAQ) to measure the physical activity level. Blood pressure
and body fatness parameters (weight, height, Body Mass Index (BMI), body fat percentage, visceral fat, basal metabolic rate (BMR), waist-hip measurement)
were measured accordingly.
Results: The mean age and BMI for the subject was 37.00 (9.42) years and 24.59 (4.33) kg/m², respectively. There was a significant inverse correlation between
Fagerstrom score and systolic blood pressure (r=-0.216, P£0.05) while there was no significant correlation with diastolic blood pressure (DBP), physical activity
level and all body fatness parameters.
Conclusion: The inverse correlation between smoking dependency and systolic blood pressure were perhaps caused by the long term adaptive behavior of
smokers, high physical activity and low body mass index.

P-S4-11

Smoking and Passive Smoking Result in Atheroma Generation in Japanese Women Without Risk Factors

Ichiro SAKUMA
Caress Sapporo Hokko Memorial Clinic
Purpose: Japanese Atherosclerosis Society (JAS) Guideline 2012 proposes treatment of hyperlipidemia depending upon presence of risk factors and then risk
chart which utilized NIPPONDATA80, a national wide cohort study. However, smoking is not included in the risk factors and risk chart, which decides whomto treat. Since the JAS Guideline promotes to check intima media thickness (IMT) of carotid artery to assess presence of atherosclerosis, we have been checking
IMT of all patients who visit out clinic for health check-up or secondary assessment of hyperlipidemia. In the present study we evaluated the presence ofthickened IMT or atheroma in women along with the JAS Guideline criteria and checked the contribution of smoking and passive smoking on the generation ofatherosclerosis.
Methods: Four hundred and ninety nine female subjects aged to 50 to 74 years who visited Hokko Memorial Clinic and whose IMT were checked were enrolled.
Subjects were divided along with the JAS Guideline depending upon existence of diseases/risk factors, firstly ischemic heart disease (IHD), secondly diabetes
mellitus, chronic kidney disease, non-cardiac cerebral infarction and peripheral artery disease, thirdly low HDL-cholesterol (C), familial history of IHD in first
degree relatives and impaired glucose tolerance, and finally blood pressure (systolic blood pressure 140 mmHg and more, or less than 140 mmHg) and LDL-C(140 mg/dL and more, or less than 140 mg/dL). Then, contribution of smoking/passive smoking on the presence of IMT thickening (1.1 mm or more) andatheroma generation (1.1 mm or more) was assessed.
Results: All subjects with IHD had IMT thickening or atheroma. Secondly and thirdly selected subjects had IMT thickening or atheroma by high percentage(~80%). Finally, subjects with hypertension and high LDL-C, and with hypertension alone had IMT thickening or atheroma by high percentage (~80%).
In contrast subjects with high LDL alone had IMT thickening or atheroma only by around 40%. In subjects without hypertension and high LDL-C 22% (7/32) had
IMT thickening or atheroma and they were all smokers and passive smokers. In subjects with LDL-C 180 mg/dL and more only 29% (9/31) had IMT thickening
or atheroma, but all smokers/passive smokers (3/3) had it.
Conclusion: Smoking and passive smoking proved to contribute to generate and progress atherosclerosis in Japanese Women without risk factors, or with only
high LDL-C which otherwise scarcely result in atherosclerosis.

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P-S4-12

Change of Central Blood Pressure Before and After Varenicline Therapy

Nobuhisa YAMADA
Yamada-Kikuchi Clinic
It is already told that central arterial systolic blood pressure (CSBP) falls after quit smoking . (2010 Japanese Society of Hypertension Takeshi Takami)
Using the HEM-9000A manufactured by Omron Method Tonometori non-invasive in our Clinic, we observed a change Augmentation Index of (AI) and central
arterial pressure at the end and before the start of treatment non smoking with varenicline.
I obtain the views we report some results.

P-S5-01

The Poster Contest of Non-smoking Promotion, and the Spread Enterprise of Picture-slide Shows on the Internet

Hiroshi NOGAMI
Coalition on a Smoke-free Environment for Kids in Japan
Every year for twenty-three years from 1988, we have been campaigning a smoke-free environment for kids. Our national campaign had two objectives, thecreation of smoke-free environments where children live and play, and role modelling on exemplars. Other aims of our campaign are smoking prevention for the
young generation and to change the atmosphere to be tolerant of smoking.
We posted up anti-smoking posters for the campaign utilizing the awarded
children's pictures, at schools, hospitals, and public places. The poster, mark, paper-slide picture(or picture-book) and catchword contest on theme of a smokefree environment for kids was held to arouse public opinion and to be effective in non-smoking education. About thousands or more works were submitted ineach campaign.
We published the twenty paper-slide pictures and picture-books of winning prize. In order to advance these pictures on the internet, the digital edit of thesedrawings were carried out by powerpoint, and published on the internet.
We will exhibit these anti-smoking campaign posters and marks, and show these digital paper-slide pictures and picture-books in an exhibition hall.
（email muen@silver.ocn.ne.jp）
The anti-smoking campaigning posters and marks :http://notobacco.jp/kids/keihatuposter/keihatuposter.htm
http://notobacco.jp/kids/mark/markframe.html
The digital paper-slide picture and picture-book show :http://notobacco.jp/muenppt/digitalppt.htm

P-S5-02

Awareness of Street Smoking Ban Regulation in Kobe City: Results of Interviews from a Pedestrian SurveyLoïc GARÇON1, Hiroshi YAMATO2, Mihoko TANIGUCHI3, Kana SASAKI3, Aki ONISHI3, Ayaka HAMAMOTO3, Nagisa MORI1, Rumi HORIE4,
Mina KASHIWABARA1, Noriaki EMOTO3
WHO1, University of Occupational and Environmental Health2, Kobe Pharmaceutical University3, The World Bank4
Although Japan has been a signatory to the WHO Framework Convention on Tobacco Control since 2004, comprehensive measures still need to be implemented
at national level to protect against second-hand smoke. Meanwhile, some local government initiatives are addressing the tobacco control. Kobe city is one of
the 112 (as of 2009) cities in Japan that implemented an ordinance prohibiting smoking on selected streets. These ordinances on restriction of street smoking
are mostly implemented for environmental beautification purposes. As part of a broader study to assess the effectiveness of the Kobe ordinance, a survey was
conducted for four weeks between August and September of 2012 through interviews of pedestrians in selected streets where the smoking ban was implemented.
One of the objectives was to determine the level of awareness of the Kobe ordinance among the interviewees. A total of 761 people were approached and 410
responded to the interview. Out of the respondents 49% acknowledged the existence of the ordinance. Significant differences were observed in the level ofawareness of the ordinance among current smokers (59%), past smokers (55%) and nonsmokers (38%). Information about noticing infringing smokers was alsocollected among these three groups. Significant differences were also observed among current smokers noticing infringing smokers (48%), past smokers (28%)
and non-smokers (24%). The results suggested a positive relation between awareness of the ordinance and recognition of ordinance violations. We suggest that, inorder to increase the effectiveness of the Kobe ordinance, a dissemination strategy needs to be implemented taking into account the different levels of perceptionof smokers, nonsmokers and past smokers. In addition, the awareness level shown by smokers suggests that street smoking bans might contribute to decreasesocial acceptability of smoking. It would provide an opportunity to introduce cessation programmes and their health benefits to smokers.

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P-S5-03

Assessing the Compliance of the Ordinance Banning Smoking on Selected Streets in Kobe City, Hyogo, Japan

Nagisa MORI1, Mihoko TANIGUCHI2, Rumi HORIE3, Mina KASHIWABARA1, Eriko DOI2, Misato KUSUMOTO2, Sakiko SHIMAI2, Keiko YAMADA4,Loïc GARÇON1, Noriaki EMOTO2
WHO1, Kobe Pharmaceutical University2, The World Bank3, Hyogo Prefectural Government4
Despite being a signatory country of WHO Framework Convention on Tobacco Control (FCTC) since 2004, Japan has not yet implemented effective measures
to protect people against second-hand smoke (SHS). Meanwhile, municipal regulations to restrict outdoor smoking on streets are increasingly common. Morethan 100 cities have implemented street smoking ban ordinances; however, the ordinances were introduced mostly for the purpose of preventing littering andbrush-by burns, without addressing health concerns. Kobe city is one of the cities that introduced such ordinance. The objective of this study was to assess thecompliance of the municipal street smoking ban ordinance in Kobe city. Two areas were chosen to compare between banned area (BA) and non-banned area(NBA). The survey was conducted for 26 days during August and September of 2012. Three different types of assessments were made both in the morning andin the afternoon, and the following information was collected: 1) numbers of pedestrians and smokers 2) number of cigarette butts and 3) concentration level of
PM2.5. Characteristics of smokers such as location and time of smoking and littering behavior were also obtained through direct observation. The prevalence ofsmokers was higher in the NBA (0.8% of the pedestrians were smoking) than in the BA (0.2%). The mean number of cigarette butts found per collection periodof 1.5 hours was 1.5 in the BA and 5.9 in the NBA. A higher proportion of smokers were observed in the afternoon (BA: 74.5% and NBA: 64.9% of all smokers
observed), most of them were male (BA: 82.4% and NBA: 89.7%), most of them were appeared to be in their 20s-30s, majority were smoking alone (BA: 75.5%
and NBA: 82%), nearly one in four smokers discarded cigarette butts on streets, and more smokers were smoking standing still in the BA (61.8%) than in NBA(42.8%). PM measurements showed no difference between the two areas. Difference between the two areas is evident from the prevalence of smokers and butts
counting rather than PM measurement. Continuous enforcement and monitoring are suggested. Smoking prevalence among pedestrians or butts counting seems
to be advisable measures for the city to conduct periodic monitoring. Education campaign particularly targeting male smokers in their 20s-30s is recommended.
Taking advantage of the high compliance, expansion of the BA is also suggested.

P-S5-04

Home and Workplace Smoking Bans and Support for Public Smoke-free Policy among Adult Smokers in Thailand:
Findings from the International Tobacco Control Thailand Survey

Charamporn HOLUMYONG1, Ron BORLAND2, Buppha SIRIRASSAMEE1, Aree JAMPAKLAY1, Teeranoot KONKEAW1
Mahidol University1, The Cancer Council Victoria2!
Corresponding author: charamporn.hol@mahidol.ac.th
Introduction: Thailand had implemented the smoke-free policy in all indoor public places that has covered at least 90% of population. However, the studies of
supports on smoke free public places and smoking bans at home and workplace are quite limited in Thailand. Thus, this study aimed to examine the prevalenceof home and workplace bans and support on smoke-free public places among adult smokers.
Materials and Methods: Data were drawn from the International Tobacco Control-Thailand survey. Five waves of survey, a cohort study conducted from 2005
to 2011 were included in the analysis which included approximately 2,000 adult smokers in each wave of survey.
Results: The prevalence of complete home smoking bans and indoor workplace bans were 34.4% and 56.0%, respectively, in 2011. The prevalence of complete
indoor workplace bans has continuously increased during 2005-2011 while that of home smoking bans significantly increased up to 2008. Considering smokers’
demographic characteristics, there have been the disparities in the prevalence of complete home smoking bans. Prevalence was low among rural residents,
smokers who resided in the southern region, young adult smokers, low educated smokers, and smokers with middle income households. Having air-conditions
associated to the smoke-free home and workplace policy. Homes and workplaces with air-conditioners tended to have higher prevalence of complete bans on
smoking.
The support on smoke-free public places among smokers drastically increased during 2005-2011. The proportion of support for complete smoking bans in non
air-conditioned restaurants jumped from very low (11.5%) to very high (78.9%). The similar trends also emerged for air-conditioned nightclubs and outdoor
warship places. Frequency of visits associated to smokers’ support for complete smoking bans in non air-conditioned restaurant and air-conditioned nightclubs.
The frequent visits tended to lower smokers’ support for complete smoking bans.
Conclusions: The prevalence of complete home smoking bans and indoor workplace bans have tended to rise as well as smokers’ support on the smoke-freepublic places. However, disparities were existed among adult smokers. Targeted campaigns among the low prevalence groups are needed to effectively protect
both smokers and non-smokers.

P-S5-05

Taipei City Citizens’ Approval Ratings for Building a Smoke-free Environment and Factors Influencing the Ratings

Li-Ju LIN, Jen-Tao LIU, Yu-Chiu CHI, Li-Hui YU, Hsiu-Lian LIN
Taipei City Goverment
Introduction: According to studies, smoking cigarettes and second-hand smoke account for more than 30% of cancers. Tobacco Hazards Prevention Act does
not include bans in public spaces; therefore, to protect the health of citizens, Taipei City Government actively promotes a smoke-free environment and establishes
outdoor designated smoking areas. This research aims to investigate how supportive and satisfied Taipei City citizens are concerning the promotion of a smokefree environment. The results will be used as a reference in planning future policies.
Method: Taipei City Government has established 45 outdoor smoke-free areas and 42 outdoor designated smoking areas. Stratified random sampling was
conducted on citizens over 18 years old via telephone surveys from September 15th, 2012 to September 29th, 2012. 2,878 valid samples were analyzed using chisquare variable test, and Bonferroni post hoc test was conducted.
Result: 96.4% of the citizens answered “very supportive” or “supportive” for smoke-free policies and 85.7% answered “very supportive” or “supportive” foroutdoor designated smoking areas. 82% said “very satisfied” or “satisfied” for policies for building a smoke-free environment. According to the chi-square test,
there was a statistically significant correlation between smoking and gender and the approval rating for smoke-free policies. Academic degree and approval
rating for smoke-free policies also showed a statistically significant correlation. The results of the Bonferroni post hoc test indicated that female approval rating
is higher than male approval rating, and that citizens whose academic degrees are elementary school are significantly more satisfied than those who hold college
degrees.
Conclusion: Most citizens are supportive and satisfied with Taipei City Government’s promotion of a smoke-free environment. Also, gender and academic
degree are two important factors that affect the ratings. Therefore, it is recommended to put gender and academic degree into consideration when promoting
smoke-free policies.
Key Words: Smoke-Free Environment, Approval Rating, Tobacco Hazards Prevention143

P-S5-06

Pilot Program of Creating 100% Smoke-free Schools in Beijing, Zhengzhou and Kaifeng of China

Ni JINGHUA
Chinese Association on Tobacco Control
In 2010, Ministries of education and health of China jointly issued the Smoke-free Standard for Elementary, Middle and Vocational Schools, the Standard forColleges, encouraging national schools to create 100% smoke-free environment accordingly. In order to explore successful experience, CATC has initiated a pilot
program in 30 schools in Beijing, Zhengzhou and Kaifeng, which includes 6 elementary schools, 6 junior middle schools, 6 high schools, 6 vocational schools
and 6 colleges. (Zhengzhou and Kaifeng are two cities of Henan province, representing less-developed inland cities, in contrast to Beijing, one of the wealthiest
and most-developed cities). By conducting tobacco control advocacy and intervention activities, all the schools have set up tobacco control system and 27 outof 30 have already met with the national standards after evaluation. Particularly for vocational schools, through a year intervention, students smoking rate has
dropped from 16.3% to 10.3%(P<0.001). During the program period, various tobacco control activities designed by schools innovatively on and out of campus
have played positive influence, not only on students and teachers, but also on their families and the communities. The best practices has developed models forother schools and can be effectively expanded to rest of country. Also, it provides support for the coming national smoke-free legislation in public places.
Keywords: smoke-free schools, tobacco control advocacy, students

P-S5-07

Analysis of Smoking Status and Motivation for Smoking Cessation before and after Establishment of a Tobacco-freeCampus at a University Hospital

Yujiro TAKAI1, Keigo TAKAGI1, Toshisuke MORITA2, Sakae HOMMA1
Toho University Omori Medical Center1, Toho University2
Objectives
We examined the changes in smoking behavior and motivations for smoking cessation before and after establishment of a tobacco-free campus.
Methods
Surveys were conducted among staff at the Toho University Medical Center Omori Hospital. Included in this study were 1,340 subjects in 2010 and 1,071
subjects in 2012 who responded to the survey.
Results
The percentage of staff who smoked (smoking rate: 2010 23.1% vs 2012 18.3%, p=0.005) and number of cigarettes smoked per day (2010 >10 45.8%, 1020 45.2%, 20< 9.0% vs 2012 >10 56.2%, 10-20 40.3%, 20< 3.5%, p=0.012) decreased significantly in the two years. As for interest in smoking cessation,
25% of the smokers were ready to quit. Regarding motivation for smoking cessation, the percentages were high for the following categories: ‘tobacco priceincrease’ (13.6%), ‘recommended by family’ (12.6%), and ‘tobacco-free campus’ (12.1%). In particular, the motivation of ‘tobacco-free campus’ was indicatedsignificantly more often by the staff who quit smoking within the two years (p<0.01).
Discussion
Our results suggest that the decline in smoking rate and the changes in smoking behavior are influenced by a tobacco-free campus, an increase in the tobacco tax
and a change in the perception of smoking in the family.
Conclusions
Although establishment of a tobacco-free campus had a significant effect in reducing the smoking rate among the staff, further measures should be taken to reduce
the number of current smokers.

P-S5-08

Smoking Restriction and Amount of Daily Cigarette Consumption among Adult Smoker: Findings from Waves 1-5 of
ITC-SEA (Thailand)

Teeranoot KONKAEW1, Buppha SIRIRASSAMEE1, Aree JAMPAKLAY1, Charamporn HOLUMYONG1, Ron BORLAND2, Geoffrey T. FONG3
Mahidol University1, The Cancer Council Victoria2, University of Waterloo3
Background: A smoke-free home policy could reduce daily cigarette consumption, support the successful quitting, and obstruct smoking initiation. Smoke-freeworkplaces also help encourage smokers to quit or reduce their consumption, reducing total cigarette consumption per employee. Therefore, the complete orpartial bans of smoking at home and workplace may affect the amount of daily cigarette consumption among adult smokers.
Objectives: 1.To follow up the smoking restriction at home and workplace over period of 5 years.
2.To explore the association between home smoking restriction and amount of daily cigarette consumption in adult smoker in Thailand from Waves 1 - 5.
3.To explore the association between workplace smoking restriction and amount of daily cigarette consumption in adult smoker in Thailand from Waves 1 - 5.
Methods: This study is part of 5 waves of the International Tobacco Control Policy Evaluation Surveys Southeast Asia (Thailand) (ITC-SEA) Project, undertaken
during 2005 - 2011. Respondents consisted of 2,000, 2,070, 2,468, 2,279 and 2,175 of samples aged between 18 – 90 years old from Waves 1 - 5. Participants
were recruited using stratified multistage sampling from 5 regions of Thailand. The sample was designed to be representative at the regional level which covered
both rural and urban areas in Thailand. The sample were interviewed in face – to - face interviewed. Descriptive statistics and Chi – square test were used fordata analysis.
Results: In Wave 1, 12% of sample reported that they lived in the home where smoking is not allowed everywhere. The proportion dramatically increased at all
the follow up surveys. For smoking restriction in the workplace, at wave 1, 45% of the sample reported working in the workplace where smoking is not allowed.
The proportion slightly increased at the all follow up surveys. For all 5 rounds, the Chi – square test indicates a significant association between home smoking
restriction and daily cigarette consumption. Nevertheless, across the 5 survey waves, there is no evidence that workplace smoking restriction is related with daily
cigarette consumption.
Conclusions: Smoke free home and smoke free work place are expanded in Thailand. There is an association between home restriction and daily cigarette
consumption. Campaigns on smoke free home should be strongly supported and strengthened to reduce daily cigarette consumption and protect Thai people
from second – hand smoking.

144

P-S5-09

Initiatives Following the Prohibition of Smoking in a Hospital and its Grounds

Yoshinobu HATA, Shinich MATSUOKA, Masaaki ADACHI, Kimiyoshi MITSUHASHI, Junichi YOSHIDA, Emiko NAGASAWA, Yukiko MATOBA,
Tomio SUGISAKI, Fumiaki SASAKI
Sapporo Social Insurance General Hospital
Purpose: Our hospital was the first in Japan to institute thecomplete prohibition of smoking on site from New Year's Day in 2000, and has subsequently carriedout various promotions about tobacco control. These measures are reported on in this paper.
Methods: Preparation began in July, 1994. In December 1999, one month before the complete ban on smoking commenced, various initiatives were carried out,
such as the display of anti-smoking posters from all over the world, the setting-up of a non-smoking consultation corner, showing a non-smoking video, andthe distribution of non-smoking pamphlets. The complete prohibition of smoking on site came into effect from New Year's Day on 2000. We have looked into
subsequent measures taken.
Results: The activities of the Non-smoking Promotion Committee have continued and every year within the week of the World No Tobacco Day, anti-smoking
posters from allover the world are displayed and lecture meetings, etc. are held. Every two years, during this period a questionnaire about the prohibition ofsmoking is carried out for outpatients and staff and the decline in the smoking rate and a change in thinking about the prohibition of smoking has been confirmed.
Collection of cigarette butts and instruction about non-smoking has been performed by a non-smoking instruction patrol that goes on rounds three times a day.
The largest recorded number of cigarette butts per month was more than 3000. Many non-smoking consultations have been performed during daily nursing
consultations, which the chief nurses take turns holding, and this is also having an effect. Moreover, from March 2006 all taxis waiting for passengers at this
hospital must be non-smoking cars. Non-smoking taxis spread throughout Sapporo from July, 2008 to more than 6000 (about 100 in 2006) vehicles.
Conclusion: It is thought that educational activities aimed at the people using the area and at hospital staff were important in order to promote the prohibition ofsmoking in hospitals and their grounds. The prohibition of smoking in hospitals and their grounds has spread throughout Japan, contributing to the improvementof tobacco control in society in general.

P-S5-10Perceptions and Misperceptions of a Smokefree Goal: Challenges for Communications

Janet HOEK, Philip GENDALL, Gregor WHYTE
University of Otago
Background: As an increasing number of countries set tobacco “endgame” goals that specify a date by which they wish to be essentially smokefree, attention
has turned to how those in the tobacco control sector communicate this objective, and what the public believe it to mean. Because public support will promote
adoption of the policies required to achieve smokefree societies, we examined New Zealand smokers’ and non-smokers’ perceptions of the 2025 goal (wheresmoking prevalence will fall below five percent), and the implications for smokefree communications.
Objectives: To explore New Zealand smokers’ and non-smokers’ interpretation of the government’s smokefree 2025 goal, announced in March 2011.
Methods: An online survey of 364 smokers and 402 non-smokers was undertaken to examine reactions to recent and potential tobacco retail policies. At theconclusion of the survey, respondents were invited to make any additional comments on tobacco control they wished to note. Of the 766 respondents, 315 (157
smokers (43%) and 158 non-smokers (39%)) took this opportunity. We analysed the resulting 44 pages of transcript using a thematic analysis approach.
Results: Many of the smokers and non-smokers who commented interpreted the smokefree 2025 goal as a forthcoming ban on smoking, a misunderstanding thatshaped the concerns they went on to raise. Smokers, in particular, asserted on their right to use tobacco, questioned implications for tourism, and raised “slippery
slope” concerns. In addition, they regarded the government’s focus on tobacco rather than alcohol as hypocritical, and suggested its reliance on tobacco excise
taxes undermined its commitment to the goal. Several also noted concerns over illicit trade. Although non-smokers showed stronger support for a smokefreesociety, they shared smokers’ concerns over the government’s role in dictating behaviour and illicit trade. Some also recognised the difficulty heavily addictedsmokers would face in becoming smokefree and, like smokers, questioned the hardship the goal might impose.
Conclusions: While based on a non-random sample, the comments made suggest widespread misunderstanding of the Smokefree 2025 goal as a coercive
objective that will force smokers to quit against their will. This confusion reflects tobacco industry arguments, compromises debate, and limits support for thegoal. We suggest communications strategies should clarify the outcome sought and directly address claims promulgated by the tobacco industry regarding illicit
trade and expanding bureaucracy.

P-S5-11

Result of Investigation about Smoke-Free Environment of Institutions in Chiba Prefecture, Japan and Consideration to
Achieve Smoke-Free Environment

Ayumu BENITANI, Keiichi HOSHINO, Yasushi AIHARA
Tobacco Mondai wo Kangaeru Kai
Background) Chiba prefecture in Japan doesn’t have any regulations that regulate smoking in public places like Kanagawa prefecture, although each municipality
takes measures to prevent passive smoking. One of our main objectives is to investigate the environments of public institutions in every municipality in
Chiba prefecture and enlightenment them. Apart from investigations, we are also involved in a wide range of activities that includes education in schools andenlightenment for citizens. Overall, we conduct the report about the achievement rate of smokefree environments in institutions in Chiba prefecture, and analyze
what is needed to maximize the achievement of smokefree environments.
Result of the investigation) We have investigated council’s cloakrooms in 2012, government buildings in 2011, and schools in 2010. In the assemblies, City
councilors could smoke in their cloakrooms in 14 out of 54 municipalities. Main government buildings were not smokefree, and officials could smoke in thebuildings in 19 out of 54. Public institutions (excluding main government buildings) were not smokefree in 33 out of 54. There were no regulations regarding
smoking in school buildings in 23 out of 54.
Our activities) In the past 6 years we have conducted about 200 presentations in schools at the request of Chiba prefecture or other municipalities. We also
conducted questionnaire investigations of schools in 2011, and of restaurants in 2009 about their smoking environments.
Consideration) From the results of the investigations, it is clear that efficient countermeasures are not taken in many institutions despite the dangerous healthhazards from passive smoking. In 2012, Chiba prefecture held a convention and created the report for the prevention of passive smoking.
Upon receiving this report, several municipalities decided to make their public institutions smokefree. However, one local restaurant district create its own rules
which permit people to smoke in restaurants.
One problem is that many citizens do not have accurate knowledge, and this report lacks an aggressively administrative approach and entrusts each municipality
or facility to create specific countermeasures that without efficient ordinance, there is the danger of spreading insufficient countermeasures in various regions. To
curb passive smoking in public spaces, the establishment of smokefree ordinance is needed in Chiba prefecture.

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P-S5-12

Singapore’s Blue Ribbon Smoke-free Movement in the Hotel Industry

Janelle CHIA, Chris CHEAH, Annie LING
Health Promotion Board
Background
Singapore has one of the lowest smoking prevalence in the Asia-Pacific region at 14.3% in 2010. However, 16.1% of Singapore residents in the workforce
smoke, with the hotel industry having one of the higher smoking prevalence among the industries, making it a natural opportunistic setting to focus smoking
control efforts. The Blue Ribbon Movement is part of the larger initiative by the World Health Organisation (WHO) Western Pacific Region Office (WPRO) to
promote a smoke-free environment. Singapore is the first country in the region to adopt this Movement, a voluntary ground-up smoke-free advocacy project ona nationwide scale. Singapore’s Blue Ribbon Movement was launched in March 2012 and has since been introduced to food centres, parks and other community
spaces with the aim to ‘de-normalise’ smoking through voluntary smoke-free environments. The hotel industry is the first to launch the Blue Ribbon Movement ina workplace setting. Although not required by law, Blue Ribbon Hotels have voluntarily created smoke-free spaces and environment, including 100% smoke-freerooms, and are committed to implementing smoke-free policies and programmes to expand the smoke-free environment for all stakeholders.
Findings
Initial assessment from a local study with the Singapore National Employers Federation (SNEF) on hotel operators in Singapore has shown that 21.7% of
employees in the hotel industry are daily smokers. Many hotels have varying levels of adoption of smoke-free initiatives across hotels, with many still at the earlystages. However, 87.5% of hotels surveyed felt that they will benefit from being 100% smoke-free, these benefits translate to beyond the health and well-being of
employees, to include their stakeholders, patrons, customers, vendors and contractors. Through the partnership of Singapore Health Promotion Board and tradeassociations such as SNEF, the Blue Ribbon Hotels Movement was launched as a pilot among 7 hotels to enable them to leverage on the Singapore Workplace
Health Promotion Grant to implement suitable smoke-free policies and customized smoking control programmes and environment for all.
Conclusion
Efforts to reduce smoking prevalence in the workplace should not be solely about addressing smoking among employees. The Blue Ribbon Hotels movement
demonstrates a more inclusive and progressive approach to expand the smoke-free environment to every stakeholder within their influence through theimplementation and enforcement of comprehensive smoke-free policies and programmes.

P-S5-13

Evaluation of Smoking Recognition among Health Officers of Japanese Companies by Using the Kano Test for Social
Nicotine Dependence (KTSND)

Yoko MATSUNAMI1, Atsuko KAWAI2
Yamagata University1, Koutokukai Total Health Clinic2
Aim. Article 25 of the Japanese Health Promotion Law was enforced in 2003. It says that persons in charge of management at facilities used by large numbersof people shall endeavor to take the necessary measures to protect users of these facilities from exposure to passive smoking. Workplaces were then divided
into smoking and non-smoking areas, and a ban on smoking indoors in workplaces at last, in theory, came into force. However, unlike Western countries, Japan
has few plans completely ban smoking in public places and workplaces. To determine why this is so, we evaluated recognition of smoking and social nicotine
dependence among health officers in Japanese companies.
Methods. We gave questionnaires (the Kano Test for Social Nicotine Dependence (KTSND), which has 10 questions with a total score of 30) to participants at
a study session run for company health supervisors and sponsored by the Yamagata Labor Standards Association. We distributed the questionnaires at the startof the study session and again at the end. The statistical significance between the start and end results was determined by using Wilcoxon’s matched-pairs test.
Results. The questionnaires were distributed to 135 participants; 106 were returned (response rate: 78.5%) and 103 were usable (valid response rate: 76.3%). The
average age of the respondents was 46.2 years; 44 (42.7%) of them were male and 59 (57.3%) were female. Fifty-five respondents (53.4%) had never smoked,
whereas 35 (34.0%) were ex-smokers and 13 (12.6%) were smokers. Twelve of the respondents (11.7%) were medical workers, and 17 (16.5%) had previously
attended stop-smoking training sessions. The KTSND decreased after training, regardless of smoking status. Although the KTSND average of non-smokers(including both ex-smokers and those who had never smoked) was lower than that of the smokers, the difference was not significant.
Conclusion. The rate of smoking (12.6%) among health officers working in Japanese companies was lower than the rate in the general Japanese population(20.1%). However, KTSND high scorers (i.e., those who tolerated smoking) and social nicotine dependence were present among non-smokers. The KTSND
scores where higher before training than after. To promote smoke-free company workplaces, education of health officers through the dissemination of informationneeds to be increased.

P-S5-14

Assessing Tobacco Smoke Situation around Smokers and Second Handed Smokers in Hospital Staffs

Pongsri SRIMORAGOT1,2, Ittipol PAU-ARMART3
Thai Nurses Network on Tobacco Control1, Mahidol University2, Ministry of National Resources and Environment3
To explore dust and chemical amount in hospital smoke during 8 office hours. Prospective survey was applied to recruit 52 volunteers who work as full time staff
in 6 hospitals after informs consent. Purposive sampling was used to recruit 8-9 volunteers from each hospital of Ministry of Public Health, or university hospital.
After complete demographic questionnaire regarding personal history, smoking history or second handed smoke experience and frequency, knowledge andawareness questionnaire regarding smoking harmfulness and impact on second handed smoke colleagues. Then they were test for vital sign, breath CO and urine
cotinine test at pretest and repeated during posttest at 8 hours before went home. Then each volunteer allow to applied air pump with fine filter and/or Charcoal
tube during smoking period for 8 office hours. All paper filter and Charcoal tubes were keep in ice cool box for stabilization of Volatile Organic Compounds andweighted for less than PM10 dust amount by high accuracy measure at Automobile Emission Laboratory, Pollution Control Department, Ministry of National
Resources and Environment. Then all samples were analyzed for PAH and BETEX at Public Health Reference Laboratory, Disease Control Department, andMinistry of Public Health based on AGCIH standard.
Results showed that all samples were contaminated with small amount of cigarette smoking dust (less than PM10). For PAH, sample were exposed less than 0.001
ug. /sample and exposed with some form of volatile organic compounds includes Benzene, Toluene, Ethyl benzene and Xylene. All volatile organic compounds
were known as environmental carcinogen and accumulate in smoker body. For very small amount of Polycyclic Aromatic Hydrocarbon (PAH) exposition, it did
not mean safe enough for long term exposure among hospital staff and colleagues. Conclusion: There is no safety level for exposure to cigarette smoking. Bothsmoker and secondhand smoke staff in hospital should be raise awareness regarding harmfulness in cigarette smoking.
Smoking in hospital area should be comprehensive ban and strong enforcement as smoke free role model of other public communities. So all level of hospital
staffs should be educated and advocated by comprehensive coordination and empowering them to be a part of smoke free idol. In addition, to achieve 100%
smoke free hospital, it is essential to provide comprehensive cessation program to smoker staff.
Keywords: Second hand smoke, direct smoker, tobacco smoke, hospital environment
Acknowledgement: Thai Health Promotion Foundation, and Thai Nurses Network on Tobacco Control under patronage of Princess Mother.

146

P-S5-15

Space Separation Is Ineffective to Prevent Passive Smoking

Masayuki TAKAHASHI, Natsuki KINOSHITA
Biwako Seikei Sport College
BACKGROUND: Passive smoking can be prevented only by smoke free policy indoor. However, space separation policy (separation between smoking area andnon-smoking area) exists in many Japanese restaurants, coffee shop and Karaoke bar/box. We aimed explore if space separation policy is effective in preventing
passive smoking.
METHODS: We picked up 40 shops in Katata district of Otsu, Shiga. After permission from owner, we measured PM2.5 particle concentration by Sidepack
AM. Shops were consisted of 22 smoke shops, 6 space separation shops, and 12 non-smoking shops. Measuring points were set around the center of the area.
Measured value was determined after stabilization of values.
RESULTS: PM2.5 concentration are shown in a Table below.
Smoking policy
Smoking permitted
No smoking shop
No smoking shop
Separate
Separate

Area
Smoking
IndoorOutside smoking
Smoking area
No smoking area

PM2.5 (μｇ/㎥)518.7**
4.4
181.7*
365.6**
113.6*

Very dangerous
safe
Very dangerous
Very dangerous
Dangerous

Table PM2.5 concentration in various shops. * p < 0.05, ** p < 0.01 vs No smoking shop indoor.
Maximum value of 814.8 was obtained in smoking permitted KARAOKE bar, followed by a family restaurant of 691. In a smoking permitted YAKINIKU
restaurant, PM 2.5 value was 406.7.
CONCLUSION: The results of this study clearly demonstrated ineffectiveness of space separation policy in prevention of passive smoking.

P-S5-16

Analysis of Dynamics in Smoking Status in Japanese Workers

Yasushi ISOJIMA, Tetsuya TERADA, Takashi KIMURA
Foundation of Kinki Health Administration center
Although the smoking prevalence of Japanese people has dropped to less than twenty percent in 2010, it is still at a higher level than that of the United Statesand European countries.
Analysis of dynamics in smoking status is necessary to discuss a way to lower the smoking prevalence. The smoking statuses used were from the medical
interview forms in the periodical occupational health checks implemented by the Kinki health administration center (KKC) from 2006 to 2011. We analyzed how
the smoking statuses of patients changed in the next year.
The rate of non-smokers who started smoking in the next year is relatively high in teenagers (male: approximately 10% in 16-18y/o and over 15% in 19y/o;female: approximately 3% in 16-18y/o and over 4% in 19 y/o), but low in adults (male: approximately 2% in 20-24 y/o and less than 0.5% in over 25 y/o; female:approximately 0.8% in 20-24 y/o and less than 0.2% in over 25 y/o). The rate of smokers who quit smoking in the next year is less correlated with age (male:approximately 5-10%; female: approximately 5-15%). The rate of former smokers who returned to smoking in the next year is high (approximately 60% inmale and 40% in female) in teenagers and gradually decreases with advancing age (over 60y/o: approximately 3% in male and 5% in female). The populationof smokers increased in teenagers (male: approximately 10% in 16-18y/o and 15% in 19y/o; female: 2% in 16-18y/o and 5% in 19y/o), were almost the same in
20-24y/o, and decreased in 25y/o and over (approximately -2.5% in male and -0.5% in female).
These data suggest that most smokers in the workplace started smoking at 20y/o and under, particularly when they had just turned 20, and could start smoking
legally. In contrast, smokers who started tobacco smoking at 21 and over are relatively few in number. Thus the education for teenagers about the ill effects of
tobacco should be strengthened in order to avoid their beginning to smoke and to decrease smoking prevalence drastically.

P-S6-01

Association between Smoking and Tuberculosis Infection

Hitoshi TAGAWA, Naoko TEZUKA, Emina FURUTANI, Tomoaki NAKAZONO, Kyoko TAKAYANAGI, Masashi INOUE, Hiroko MUTSUKAWA,
Hironobu SUGITA, Akira OKAYAMA, Tadao SHIMAO
Japan Anti-tuberculosis Association Daiichi Dispensary
Objective: Clinicians and public health workers working to fight TB may not see a role for themselves in tobacco control because the association between
tobacco and TB has not been widely accepted in Japan. Although the association between smoking and TB has been internationally reported, there are few reports
about the influence of smoking on the risk of developing TB infection. The purpose of this study is to examine the association between smoking and TB infection.
Methods: Tuberculosis contact survey was carried out at public health centers and the subjects were referred to Daiichi dispensary from July 1, 2011 to June 30,
2012. Among the subjects aged 20 years or over, 408 current smokers with QFT(QuantiFERON-TB Gold In –Tube)positive were selected as TB infected and
260 with QFT negative were selected as controls. Information on smoking status was collected from TB infected and controls using a self-reported questionnaire.
Current smoking rate of general population was collected from National Nutritional Survey in 2009.
Results: TB infected with QFT positive showed higher rate of current smoking than the controls with QFT negative.(P<0.05).Current smoking rate of the TB
infected with QFT positive of men and women in each age group were compared with general population. There was tendency of higher smoking rate in the TB
infected with QFT positive except for 20th to 30th age group of men.
Conclusion: Despite the limitations due to various biases such as selection bias, information bias or confounding factors, this study showed probable positive
association between tobacco smoking and tuberculosis infection. Although further studies should be conducted to investigate this association, clinicians canconfidently advice smoking patients that quitting smoking is important to prevent TB infection in TB control.

147

P-S7-01

Smoking Habits among Pregnant Women in Hungary

Iidiko RÁKÓCZI1, Andrea FOGARASI-GRENCZER2, Peter TAKÁCS1, K. L. FOLEY3, Peter BALAZS2
University of Debrecen1, Semmelweis University2, Davidson College3
Background:Hungary is among the worst countries in the European Union for smoking prevalence, ranking 25th out of 27 countries. 38% of the population
smokes. Smoking is an important issue related to the pregnancy and the foetal development; both first and second-hand smoking are related to low birth weightbabies.
Methods:We conducted an epidemiological study on the relationship between tobacco use, maternal and child health in the least developed four north-easterncounties in Hungary and in a district of the capital Budapest between 2009 and 2011. During this period, there were 17,343 live births in these regions, of which
13,057 mothers completed our in-person survey (75.4%). The purpose of this analysis was to evaluate pregnancy-related changes and women’s tobacco use
attitudes. SPSS was used for all analyses.
Results: 41.56% (n=5,062) of women were smoking prior to pregnancy. When they learned they were pregnant 19.5% (n=981) continued smoking at the samerate as before pregnancy (1st group), 43.8% (n=2,222) continued smoking, but reduced the daily number of cigarettes (2nd group), and 36.7% (n=1,859) quitted(3rd group). Birth weight and length of pregnancy were significantly different in the three groups (Kruskal-Wallis nonparametric test, p<0.001). When comparing
the length of pregnancy, the difference was small in mean values (3-4 days) but considerable in the birth weight; there was 460 gram difference between the 1st
and the 3rd groups. This is a 14% difference between groups when comparing average birth weight (3,211 gram). Those who continued smoking used 2 cigarettes
more than women who quitted (10.55; 8.09). The difference was significant between the two groups (Mann-Whitney probe, p<.001). Recidivism is considerable
after the delivery. 21.9% (n=407) of women who quitted returned to smoking already in the first week.
Conclusions: High rates of prenatal tobacco use warrants committed resources to public health programs focused on pregnant women. Strategies that haveworked in other settings, such as in-person assistance and small group trainings by the A5 method (ask, advise, assess, assist, arrange follow up) provided by theMaternity and Child Health Service, supported by the recent strong clean indoor air laws enacted in Hungary could have a positive impact to change the attitudes
in this heavily smoking population.

P-S7-02

Health Risks of Second-Hand Smoke on Women in Sukhothai Province, Thailand

Sane SAENGNGERN1, Naroongsak NOOSORN2, Somkid TUNTIWITAYAPAN1
Sukhothai Provincial of Public Health Office1, Naresuan university2
Tobacco smoking has been a custom and addiction primarily of men, the home is the predominant location for smoking. Many women are exposed to tobaccosmoke in their daily lives from their husband. Second-hand smoke causes many of the same diseases as direct smoking. So this research was a cross-sectional
survey research aimed to examine the relationships between women their husband smoke and non smoke, symptom and incidence of diseases. 468 participants
were random by using multistage random sampling. Data was collected between 1 September 2012 to 31 October 2012. The interview/questionnaires were used
as a tool for data collection and then analyzed by percentage, mean, standard deviation, chi-square and odds ratios (OR), confidence intervals (CI).
The result showed that the average of age 47.12 years old, average duration of marriage 25.19 years, primary education (59.20%), casual laborers (46.30%).
Concerning the relationship between second-hand smoke and health problems, it was found that women their husband smoke were likely to suffer fromdiminished sense of taste and smell than those who non-smoke 1.62 times (OR=1.62, 95% CI=1.02-2.57), women their husband smoke were likely to suffer fromnose and eye irritation than those who non smoke 1.78 times (OR=1.78, 95% CI=1.06-2.98), women their husband smoke were likely to suffer from chronic
coughs than those who non-smoke 2.17 times (OR=2.17, 95% CI=1.47-3.21), women their husband smoke were likely to suffer from high blood pressure thanthose who non-smoke 3.43 times (OR=3.43, 95% CI=2.30-5.11), women their husband smoke were likely to suffer from frequent colds than those who nonsmoke 1.94 times (OR=1.94, 95% CI=1.31-2.88), women their husband smoke were likely to suffer from bad breath than those who non-smoke 1.87 times(OR=1.87, 95% CI=1.19-2.92). From this research results should focus on counselingand education of health effect from second-hand smoke in the home and develop tobacco-free family campaigns at the community.
Key word: health risks, second-hand smoke, women

P-S7-03

The Risk Factor of Smoking on Birth Outcomes

Nan Hee YEE
Korea Institute for Health and Social Affairs
Birth outcomes are very important to the future health of children. The purpose of this study is to identify the relevance of maternal smoking and birth outcomesusing Korea Infants Mortality Data. This study shows that maternal smoking seems to be associated with birth outcomes such as birth weights and gestational
age. According to results, maternal smoking appears to be a risk factor for birth outcomes.

148

P-S7-04

Effects of Age at Smoking Initiation of Pregnant Women on Subsequent Smoking Habits

Fumiaki SUZUKI1, Takahiro KASAMATSU2
Taniguchi Hospital1, Kobe City College of Nursing2
Objective: The age at which pregnant women started smoking may affect subsequent smoking habits. We therefore investigated the age at smoking initiation ofpregnant women and smoking habits during pregnancy in order to elucidate the effects of age at smoking initiation on subsequent smoking habits.
Background. toThis
investigating
the 5993
changesin
Methods: An anonymous self-report questionnaire survey on smoking habits was administered
4788study
womenwas
who aimed
providedatconsent
from among
pregnant
women who gave birth at hospital A between January 1, 2008 and August 31,circumstances
2012. Surveyand
contents
included: ageonatthesmokingsmokingand
habitsthe consciousness
part of initiation;
pregnant smokers
induring pregnancy; number of cigarettes smoked; smoking location at home; smoking
the car whilewith a non-smoker;
Kano Test
for Social
Nicotine
their inexposure
to theriding
environmental
tobacco smoke(ETS).
Methods.
The
Dependence (KTSND); Fagerstrom Test for Nicotine Dependence (FTND); experience of quitting smoking; desire to quit smoking; and smoking habits ofsubjects in this study were 4,504 pregnant women during April 2001 to
husbands, family members, and parents. Pregnant women with a history of smoking were classified by age at smoking initiation into the £15-years group (started
December
2012, ranging
from 16 habits.
to 44 years in age. Results. Smoking rates atsmoking at age £15 years) and the ³16-years group (started smoking at age ³16 years)
for comparisonof smoking
menstrual
period decreased
from 21.3%
to indicated
13.0% (2012),
andat
Results: The response rate was 90.9% (4351/4788); 1,730 pregnant women hadlast
a historyof smoking.
A total of 1,479
of these(2001)
women
their agesmoking initiation (£15-years group, n=411; ³16-years group, n=1,068). Comparedto therates³16-years
group, the£15-years
group hada higherof tosmoking
Smoking
at pregnancy
notification
decreasedfrom
7.0% rate(2001)
1.7%
during pregnancy, a higher number of cigarettes smoked, a higher rate of smoking(2012).
in the carwhile riding
withnon-smoker,family
and aincreased
higher rateof havinghusbands
Pregnant
women
witha smoke-freefrom
25.7% (2001)
toor parents who smoked. No statistically significant intergroup differences were observed
for smoking
location,
FTND,
of quitting
smoking,
57.5% (2012)(See thefigure). KTSND,
Methods for
ETS experience
control in home
are changing
inor desire to quit smoking.
the same period. “Smoking only outside” increased from 17.0% to 36.1%, while
Discussion: Nicotine dependence was not related to age at smoking initiation or subsequent smoking habits. These findings suggest that smoking habits are“smoking
anywhere”
from 31.4%intowhich
9.0%.the“Usinga ventilationfan”
negatively influenced by those of smokers’ parents—in other words, the presenceof cigarettesmokedecreasedin the environment
pregnant
women were“usingair purifier”
was 3.3%,
althoughnoneof thesesmoking
measuresraised during infancy. Smoking among pregnant women causes passive smokingwas
by 28.7%,
the fetus,
and ansmokingby parents
not only
resultsin passivebychildren but may also raise the risk of children starting to smoke from an early age.
Thorough implementationofThemeasuresto ofhelp
pregnant
quitaboutsmoking
substantiallyreduce exposure.
numberpeoplewho women
recognize
theis necessary to break the generational cycle of smoking initiation.
risk of pregnant smoking is consistently increasing. In period from 2001 to 2012,
Key words: pregnant women, pregnancy, smoking habits, age at smoking initiation“mental retardation“ increased 1.3 times as much, “infertility” increased 2.1 times,and “erectile dysfunction“ increased 3.3 times. Conclusion. The percentage ofpregnant smokers is steadily decreasing in pararelle with the steady increase in
P-S7-05
Decrease of Pregnant Smokers and Changing of Exposure
Environmental
TobaccoSmoke
in Pregnant
Women
the topercentage
of pregnant
women withsmoke-freefamily. There
should be afurther
improvementincircumstances
surrounding
pregnant
women who are
Masaaki YAMAOKA
subject to ETS.
Sumoto Emergicenter

Background. This study was aimed at investigating the changes incircumstances and the consciousness on the part of pregnant smokers andin their exposure to the environmental tobacco smoke (ETS). Methods. The
subjects in this study were 4,504 pregnant women during April 2001 to
December 2012, ranging from 16 to 44 years in age. Results. Smoking rates
at last menstrual period decreased from 21.3% (2001) to 13.0% (2012), andSmoking rates at pregnancy notification decreased from 7.0% (2001) to
1.7% (2012). Pregnant women with smoke-free family increased from 25.7%(2001) to 57.5% (2012) (See the figure). Methods for ETS control in home arechanging in the same period. “Smoking only outside” increased from 17.0%
to 36.1%, while “smoking anywhere” decreased from 31.4% to 9.0%. “Usinga ventilation fan” was 28.7%, “using an air purifier” was 3.3%, although noneof these measures substantially reduce exposure. The number of people who
recognize about the risk of pregnant smoking is consistently increasing. In
period from 2001 to 2012, “mental retardation“ increased 1.3 times as much,“infertility” increased 2.1 times, and “erectile dysfunction“ increased 3.3
times. Conclusion. The percentage of pregnant smokers is steadily decreasingin pararelle with the steady increase in the percentage of pregnant women withsmoke-free family. There should be a further improvement in circumstances
surrounding pregnant women who are subject to ETS.

70%

Pregnant smoker & Pregnant women with smoke-free family
in Sumoto city
Pregnant women with smokefree family

60%
50%

Smoking rates at pregnancy
notification

40%
30%

57.5%

Smoking rates at last menstrual
period34.7%

44.5% 43.4%

47.7% 48.4% 47.5%

49.8%

36.8% 35.4% 36.4%

25.7%

24.8% 23.9%
23.7%
23.4% reported
Women's smoking
has been
to influence children, such as a
21.5% 21.7%
20.5% 20.7%
premature delivery, incomplete development, developmental
17.6% diseases, etc. A
20%
21.3% was carried out for twelfth grade students for the purpose 15.0%
questionnaireof
13.0%
finding out whether
a mother's smoking affects her child's attachment formation
8.3%
7.0%
6.9% 5.8%
6.4% smoking
5.9%
or10%
not andwhether future
is promoted
childrenbythesurrounding
5.3% to
4.6%
4.1% 4.1%
2.2% 1.7%
smoking or not. Although 89.0% of students did not show interest in tobacco,student
whose mothers smoke showed concern to all the items related to0%2002 who
2003
2004 20052006
2009 20102011 2012
tobacco.2001
A student
has mother,a friend
or a2007
sibling2008
who smokes
predictedthat he or she will probably smoke in the future rather than a student who does
not satisfy the previous conditions. Children of smoking mothers felt that theywanted their mothers to care about them 2.5 times in the childhood termcompared with children of mothers who do not smoke. There was no relation
with theof fathers. For women
who want
have a childand in the
P-S7-06
Effects of Maternal Smoking to the Smoking Intention andto smoking
The Attachment
Formation
oftoMinors
innow
Japan
future, smoking has greatly become not only a health issue but also a possibilityof affecting the child's attachment formation in child rearing and because of that
Keiko AOISHI1, Ikuyo FUJIMARU2, Toshiharu ETO1
it is an important issue.
1
2

Miyazaki University , Chubu University

Women's smoking has been reported to influence children, such as apremature delivery, incomplete development, developmental diseases,
etc. A questionnaire was carried out for twelfth grade students for the
purpose of finding out whether a mother's smoking affects her child's
attachment formation or not and whether future smoking is promoted
to children by the surrounding smoking or not. Although 89.0% of
students did not show interest in tobacco, student whose motherssmoke showed concern to all the items related to tobacco. A student
who has mother, a friend or a sibling who smokes predicted that he or
she will probably smoke in the future rather than a student who does notsatisfy the previous conditions. Children of smoking mothers felt thatthey wanted their mothers to care about them 2.5 times in the childhood
term compared with children of mothers who do not smoke. There wasno relation with the smoking of fathers. For women who want to havea child now and in the future, smoking has greatly become not only ahealth issue but also a possibility of affecting the child's attachment
formation in child rearing and because of that it is an important issue.

Table: An association between neighboring smokers and interest to a tobacco
Circumference smokers
Non
MotherSiblings
Friends
smokers
The interest to a tobacco
There is it
6 (6.1)6 (20.7)
5 (15.2)
8 (16.3)
There is not it
92 (93.9)*
23 (79.3)†
28 (84.8)
41 (83.7)
I will smoke in the future
I think that I will smoke
I think that I will not smoke

5 (5.1)6 (20.7)

6 (18.2)

10 (20.4)

93 (94.9)*

23 (79.3)†

27 (81.8)

39 (79.6)**

I will smoke once in future in life
I think that I will smoke

19 (19.4)

13 (46.4)

15 (46.9)

20 (40.8)

I think that I will not smoke

79 (80.6)*

15 (53.6)*

17 (53.1)**

29 (59.2)**

What thought to want you to mind a little more in childhood9(31.0)*a11(33.3)**b9(18.4)

There is not it
85(87.6)
20(69.0)
Number (%)、Chi-square test, Fisher’s test** p < 0.01, * p < 0.05, † p < 0.1
a: odds ratio 2.52, confidence interval 1.06- 5.99
b: odds ratio 2.94, confidence interval 1.30- 6.64

There is it

12(12.4)

22(66.7)40(81.6)

149

P-S8-01

Outreach Activities for Tobacco-Free Carried Out by Nursing Students

Risa NAKAYAMA1, Hitomi YAMAZAWA1, Naomi MIKAMOTO1, Yurie ONO1, Siori KURAMOTO1, Chizuru OKAMOTO1, Kaoru INOUE4,
Shinji ISHIKAWA2, Atsuko AOKI3, Masako SHIGETA1
Kyoto Prefectual University1, Kyoto First Red Cross Hospital2, Kyoto Association for Tabacco Control3, Kyoto Tachibana University4[Background and Purpose] Nurses have to be a role model in tobacco control, however, the smoking prevalence among nurses was higher than among the general
population. Considering the situation as weakness of tobacco-control in Japan, Kyoto Association for Tobacco Control (KATC) and Kyoto Prefectural Universityof Medicine encouraged the participation of nursing students into the school-based outreach activities. A substantial number of nursing students participated in
the activities. We review the activities in chronological order and evaluate the benefits and feasibility.
[Methods and Result] Nursing students started participating in the school-based outreach activities so called “Tobacco Free Caravan in Kyoto” in 2005. At firstsome students who were interested in the activities participated voluntarily using their free time. A nursing school attached to Kyoto First Red Cross Hospital
joined into the activities as a part of practical training since 2010.
Since 2007 nursing students have performed the role of presenter and central character. The number of nursing students involved was 8 person (4 schools,
17 times) in 2005, 10(6, 21) in 2006, 6 (13, 23) in 2007, 15(21, 45) in 2008, 8 (17, 23) in 2009, 18 (44, 79) in 2010, 48(36, 91) in 2011 and 33(32, 57) in 2012.
The high school students tended to concentrate to the lectures when the nursing students spoke. At workshops they entered into casual conversation to nursing
students more immediately than to professions. The nursing students acquired basic understanding of health damage from tobacco.
From 2009 to 2011, nursing students were entrusted with organizing the Tobacco-Free Caravan on the World No Tobacco Day in a shopping mall close to
Kyoto Station. Nursing students were organizing committee to recruit staff and to prepare the event with medical students. On the day of the event we (5 nursing
students in 2009, 11 in 2010 and 20 in 2011) set up the site and worked as presenters and performers. The events attracted large crowds (500~1000 people)
and the guests really enjoyed a tobacco quiz and prizes. Over 100 smokers participated in measurement of CO every year and over 20 smokers expressed theirdetermination to quit smoking.
[Discussion and Conclusion] Nursing students are expected to take a position on leaders and activists in outreach activities for tobacco-free. These activities are
considered effective to both promote tobacco-free in community and to educate nursing students. However the number of nursing students involved remains
restrained because of rigidness of the curriculum. Participation in these activities should be part of core curriculum.

P-S8-02

Effect on Doctor’s Knowledge, Attitude, and Practice of Tobacco Control of Creating Smoke-free Hospital in 60
Hospitals in Beijing, Shanghai and Guangzhou of China

Na ZHAO
Chinese Association on Tobacco Control
Objective Through creating smoke-free hospital activities, to know the current smoking status of doctors, understand their tobacco control knowledge, attitude
and practice, and evaluate the effect.
Methods 60 hospitals in Beijing, Shanghai and Guangzhou were selected to develop creating smoke-free hospital activates, and to carry out tobacco control
interventions in whole doctors, before and after tobacco control intervention, 19580 doctors and 20772 doctors from 60 hospitals were surveyed with questionnaireon their smoking status, tobacco control knowledge, attitude, and practice, and to know the changes.
Results Through a year tobacco control intervention, the doctors’ smoking rate decrease from 10.7% to 6.8%, and the difference was statistically significant(P<0.001), the rate of often ask patients’ smoking status increased from 55.0% to 68.9%; The knowledge about tobacco’s hazard and smoking and related disease
was increased significantly in different decent.
Conclusion Through a year’s tobacco control intervention, the intervention effect is significant; the doctors’ smoking rate decreased significantly, the awarenessof tobacco control knowledge increased; the hospitals’ smoke-free environment was improved.
Keywords: doctors, smoking, tobacco control

P-S8-03

The Tobacco Control Team in a Core Hospital and Citizens Join Forces to Take Up the Challenge Against Tobacco in
Omihachiman, Japan

Yohei HOSOKAWA1,3, Hiromi MORI1,3, Ikuko TANAKA1,3, Rumiko TERADA1,3, Yukiko NAKAGAWA1,3, Kiyomi NISHII1,3, Satoshi TANABE1,3,
Hatsumi KATAYAMA1,3, Kaoru INOUE2,3, Atsuko AOKI3, Masako SHIGETA3,4
Omihachiman Community Medical Center1, Kyoto Tachibana University2, Kyoto Association for Tobacco Control3, Kyoto Prefectural University of Medicine4[Background] The relationship between tobacco and illnesses has not spread to many people especially in rural communities. Omihachiman has a populationof 80,000 and half of whom live in rural areas.
[Purpose] Aiming to reduce the number of smokers and tobacco-related disease in the community, we established the tobacco control team at the hospital in 2004
and have been promoting tobacco free activities both inside and outside the hospital. We have been always conscious to involve local citizens. We reviewed theactivities and evaluated the effectiveness.
[Methods] In the hospital we conducted various activities as follow; (1) smoking cessation clinic for both patients and citizens (2) smoking cessation advice forin-patients (3) alternating display of high impact posters (4) holding regular seminars on World No Tobacco Day (5) education about tobacco for newly-hired
staffs (6) making smoking history (active and passive) required in clinical chart (7) establishing smoke-free policy for meetings and parties. We also have been
providing leadership in community-based activities such as (1) organizing a stand about tobacco at the city health festival with the medical association (2)tobacco-free lectures in schools with the community children center (3) tobacco-free seminars in workplaces, local municipal offices and community centers (4)promoting “stop the second hand smoke for children” message in association with doctors, dentists and pharmacologists.
[Result] The team consists of 16 health professionals and secretaries and could work proactively and cooperatively. The smoking cessation clinic has beenworking consistently with 40 patients per year, involving a number of doctors and nurses of whom 9 staffs have become specialist for smoking cessation. A
smoking prevalence among hospital staffs was remarkably low at 8.9% in 2012. The outreach activities increased in number year by year (16 times in 2011).
[Conclusion]Hospital based tobacco control conducted by the team was working effectively and had an influence on community based tobacco control. We
should take advantage of our acquired skills to promote a smoke-free city.

150

P-S8-04

Changes in Behavior and Perception Regarding Smoking among Japanese Nursing Students from 2003 to 2009~

Atsuko NAKAZAWA1, Masako SHIGETA2, Naomi MIKAMOTO2, Atsuko AOKI3, Yoshiyuki WATANABE2, Kotaro OZASA6, Kaoru INOUE4,
Takako MOURI2, Naoko MATSUMOTO6
Doshisha University Health center1, Kyoto Prefectural University of Medicine2, Heian Girls University3, Tachibana University4, Radiation Effects Research
Foundation5, Kyoto Nurcing Association6
Objective: We determined the changes in smoking status, knowledge of smoking-related diseases, and attitudes to smoking among nursing students over 6 years.
Methods: Subjects were a total of 6,703 nursing students in Kyoto, Japan. Data were gathered by means of a self-administered anonymous questionnaire survey
which was conducted by Kyoto Nursing Association in 2003, 2006, and 2009. The questionnaire included questions about the smoking status, knowledge of, andattitudes to smoking. Percentage calculation, chi-square, and ANOVA were used in the assessment of the data.
Results: The prevalence of current smokers decreased from 13 to 8% and the prevalence of never-smokers increased from 64 to 71% over the 6 years. The
prevalence differed by age group. Among those in their thirties, the prevalence of current smokers was the highest (27% in 2003, 32% in 2006, 18% in 2009)
and, among teenagers the percentage of current smokers was the lowest (7% in 2003, 4% in 2006, 2% in 2009). Knowledge of smoking-related diseases changed
little during the period, and the current and former smokers had better knowledge than the non-smokers. Knowledge was not related to smoking behavior. Only
about half of the non-smokers and about a quarter of the smokers thought that smoking was not desirable for health professionals and this was almost constantthroughout the years. Around 90% of the non-smokers thought that smoking was not desirable for their own health, but two thirds of the smokers thought so.
Nearly 90% of the non-smokers and about three quarters of the smokers thought that smoking was not desirable for children, fetuses, and embryos. Thesetendencies changed little during the 6 years.
Conclusion: Despite the smoking prevalence showing a decline, knowledge ofsmoking-related diseases did not change significantly. Attitudes to smoking were still rather accetable for smoking even among non-smokers. More comprehensive
anti-tobacco education must be promoted for nursing students.

P-S8-05

The Impact of Brief Smoking Cessation Counselling in a Tertiary Acute Care Hospital

Shu Yi LEE, Nora SAID, Kay Choong SEE
National University Hospital
Background: On average, Intensive Counselling for smoking cessation takes 30-45 minutes, which is thrice the time needed for Brief Counselling. Additionally,
medications to assist in smoking cessation are costly or may be contraindicated in hospitalized patients. The outcome of Brief Counselling alone, without the useof pharmacological adjuncts, has not been well-explored.
Objective: To determine the effect of Brief Counselling alone on six-month smoking cessation rates among inpatients in a 1032-bed tertiary acute care hospital(National University Hospital, Singapore).
Methods: From April 2011 to Apr 2012, medical inpatients who were current smokers at the time of admission, and who declined Intensive Counselling, werestudied. Specialist nurses reinforced the benefits of smoking cessation and explored coping strategies. Outcomes were measured by telephonic self-reported
smoking cessation rates at six months after a set quit date. Successful cessation was defined as fewer than three relapses within the six months, with fewer than
three sticks of cigarettes smoked per relapse. Multivariable logistic regression was performed using the six-month cessation success as the dependent variable.
Independent variables were age, gender, Fagerstrom score, annual income (<USD 10K vs. > USD 10K) and marital status (married vs. no partner).
Results: Two hundred and forty-four smokers (216 males, age 58±13 years) with various medical conditions (65.2% cardiac, 29.1% respiratory, 5.4% neurological,
1.7% others) underwent Brief Counselling. Average Fagerstrom score was 3.9 (SD 2.5, median 4, interquartile range 2-6). Excluding 31 smokers who were lost
to follow-up, 35.2% (75 subjects) reported successful cessation at six months. On logistic regression analysis, a higher Fagerstrom score was associated witha significantly decreased odds of successful cessation at six months (OR 0.85 for every one point increase, 95% CI 0.77-0.94, p = 0.006), married status was
associated with an increased odds of success (OR 2.22, 95% CI 1.13-4.38, p = 0.021), annual income <USD 10K was associated with a decreased odds of success(OR 0.44, 95% CI 0.22-0.85, p = 0.014), while age and gender were not significantly associated with success (p>0.3 for both).
Conclusions: Brief Counselling by specialist nurses for smoking cessation among hospitalized patients, without using pharmacological adjuncts, can bereasonably successful. Quit rates may be affected by Fagerstrom score, marital status, and annual income.

P-S8-06

Tobacco Counselling Practices by Primary Care Providers: Perspectives of Patients

Rajmohan PANDA, Divya PERSAI
Public Health Foundation of India
Background: Inter-personal counselling by health care providers is one of the best practices in tobacco control. However, very few studies assessed counselling
practices of Primary Care Providers (PCPs) from the perspectives of patient especially in developing county such as India. Present study aims to assess theperspectives of patient on counselling practices of PCPs working in primary health care facilities in two high tobacco burdened states of India.
Methods: A cross-sectional study was conducted in the forms of exit interviews among 1559 tobacco users visiting primary health care facilities in the state ofGujarat and Andhra Pradesh in the year 2012. Respondents were selected by random sampling and information on counselling practices and intention to quit
tobacco use after getting counselled was obtained by semi-structured questionnaire. Chi-square test was employed to test the association between different
variables.
Results: Overall, 43% respondents indicated that they were never asked about tobacco consumption habit. Relatively more female (50%) were ‘never asked’
about tobacco use as compared to male (41%). More than half of the respondents (57%), who were asked about their tobacco consumption habits, indicated thatthey were never been counselled on ways of quitting. A majority of patients (82%) received information on harmful health effects of tobacco followed by benefitsof quitting (80%). Disappointingly, information on willingness ways to quitting was given only to half of the patients. Information sharing on medications forquitting and follow-up activities was undertaken merely by 12% and 10% of PCPs respectively. Significant difference was observed in tobacco history taking
and counselling practices of PCPs in the two states (p<0.05). Although almost all the patients mentioned that they are planning to reduce and quit tobacco use
after getting counselled by the PCPs yet, only one-third (30%) mentioned that they decided a quit date.
Conclusions: Tobacco use screening was practiced by about half of the primary care providers but information given was limited only to harmful health effects
and benefits of quitting. There is a need for intensive and comprehensive capacity building in tobacco cessation to motivate patients to quit tobacco use in primary
health care settings in India. This is important as primary care providers are role model and patient are likely to hear their advice especially when they relate
tobacco consumption to disease morbidity and mortality.

151

P-S8-07

Advices of Quitting Smoking Are Necessary on Health Check-up.

Nobuhito ISHIKAWA1, Miyako TAKADA1, Katsura YAMAKADO2, Tokiko INOUE1, Miho UEDA1, Junpei TAKAAKI1, Daisuke MATSUI3, Sayuki TORII4,
Atsuko NAKAZAWA5, Masako SHIGETA3
Kyoto First Red Cross Hospital1, Kyoto Association for Tobacco Control2, Kyoto Prefectural University3, Siga University4, Doshisya University5[Backgrounds] In Japan, metabolic syndrome attracts attention recently as one of the biggest illness causing ischemic heart disease (IHD) and stroke. Therefore
Ministry of Welfare and Labor introduced specific health checkup and specific counseling guidance system focused on metabolic syndrome (SHC&SCG) in2008. But in this system, smokers who are not obese and who already received medication are excluded from specific counseling guidance.
[Objective](1)To clarify the proportion of exceptions from SCG(2) To investigate the efficacy of the advice.
(3)To compare their health behaviors between smokers and nonsmokers.
[Subjects] The subjects were 2,943 men(58.1±9.7years old), who participated in SCG on both 2008 and 2010.
[Methods] The subjects were categorized into the four groups according to the following criteria;
A: Already diagnosed with hypertension, hyperlipemia or diabetes, B: Metabolic syndrome (Obese with metabolic risk factors>2), C: Metabolic syndrome
suspected (Obese with metabolic risk factor), D:Not obese. We investigate smoking prevalence and quitting rate among 4 groups. We analyzed differences of
behaviors between smokers and nonsmokers by χ2 test.
[Results] Subjects consisted Group A; 850(28.9%), Group B; 615(20.9%), Group C; 891(30.3%) and Group D; 584(19.8%). Number of smokers (smoking
prevalence) in each group are 115(13.5%), 164(26.7%), 187(21.0%) and 116(19.9%). Number of quitters (quitting rate) on 2010-SHC were 29(25.2%),
46(28.0%), 40(21.4%) and 22(19.0%). Smokers skipped breakfast more than non-smokers and practice exercise less than nonsmokers.
[Discussion] Due to national standard on SHC&SGC, 36% of smokers cannot receive counseling guidance. Advices on health check-up were very effective
regardless with or without metabolic syndrome. Smoking aggravates eating behavior and physical activity related to metabolic syndrome.
[Conclusion] Advices of quitting smoking are necessary on health check-up even if targeting metabolic syndrome.

P-S8-08

Smoking Prevalence and Factors among Nursing Students in Kyoto, Japan

Naomi MIKAMOTO1, Masako SHIGETA1, Atsuko NAKAZAWA3, Naoko MATSUMOTO4, Takako MOURI2, Daisuke MATSUI2, Isao WATANABE1,
Etsuko OZAKI1, Nagato KURIYAMA1, Yoshiyuki WATANABE1
Kyoto Prefectual University of Medicine1, Kyoto Nursing Association2, Doshisya University3[Background] The smoking prevalence among nurses was higher than nationwide according to the surveys conducted by the Japanese Nursing Association in2001 and 2006. It is an extremely serious problem for public health because they have to be a role model in tobacco control in addition to the risks to their own
health. Furthermore there are few large-scale studies which have analyzed the smoking prevalence and factors associated with smoking among the nursing students
in Japan. [Objective] To determine the smoking prevalence among female nursing students and to investigate the factors associated with smoking, we have
performed this study. [Methods] The subjects are 2,636 female nursing students(26.2±6.7years old) who filled in self-administered anonymous questionnaires
conducted by the Kyoto Nursing Association in 2009. After recognizing big differences in smoking prevalence between generations, we assumed 8 factors. A:
type of school (university, nursing school, nursing school thorough assistant course=alternative nursing schools), B:current school year, C: whether they enteredschools directly or not, D: health conditions, E: the number of family members, F:smoking status of family members, G: smoking status of female friends
H:smoking status of male friends. Then we analyzed the age-adjusted smoking prevalence by these 8 factors using χ2test. [Results] The overall current smoking
prevalence was 284(10.8%). The smoking prevalence in their age groups was 3.1%(18~19y.o.),9.7%(20~23y.o.),24.5%(24~27y.o.),24.7%(28~31y.o.),22.0%(32~35y.o.),20.4%(over 36y.o.) respectively. The age-adjusted smoking prevalence was A:6.0%,9.2%,21.1% (university, nursing school ,alternative nursing school),
B:11.8%,9.5%,10.4%(1 ,2,3+4 school year), C:4.6%,11.0% (directly, not directly), D:8.9%,11.0% ,17.4% ,19.1% (very good, good, not good, bad in healthcondition) , E:9.8%,11.7%,11.1%,10.9%(1,2~3,4~6,over 7 family members), F:14.9%,6.6%(family members smoke, don’t smoke), G:13.1%,0.3%(female friends
smoke, don’t smoke),H:12.6%,3.0%(male friends smoke, don’t smoke). Factors excluding B and E had significant differences. [Discussion] These results suggestthat the smoking prevalence might be affected by economic condition, academic ability, and smoking status around them. Smokers were found to be groupedin certain demographics which are hard to reach through conventional educational means. Therefore the interventions should be both comprehensive and tailormade such as improvement of environment around school, education corresponding age and support smokers to quit using behavior therapy. [Conclusions] Eldernursing students definitely smoked more than younger students. After age-adjusting, the smoking prevalence was associated with the type of school, whether they
entered schools directly, health condition, whether they have family members who smoke and whether they have friends who smoke.

P-S8-09

Smoking Cessation Services among Thai Community Health Nurses

Surintorn KALAMPAKORN1,2, Supanee SENADISAI2,3
Mahidol University1, Nurses' Network for Tobacco Control of Thailand2, Thailand Nursing and Midwifery Council3
Since most of Thai smokers live in the rural community, smoking cessation services provided by community nurses are needed. The objective of this study was
to examine smoking cessation activities of Thai community health nurses and its related factors. The sample was 416 nurses working at primary care units andcommunity hospitals in all regions of Thailand selected by stratified random sampling method. Association between personal factors, situational factors, andsmoking cessation activities were examined. A self-administered questionnaire was mailed to the 522 sample of community health nurses for data collection, 416
responded (79.7%). Data were analyzed using descriptive statistic, Pearson’s product moment correlation coefficient, and stepwise multiple regression analysis.
Results showed that most of subjects had the smoking cessation activities at a moderate level (75.2%). The activities mostly performed by nurses was asking
for smoking history of clients, while the activity lowest performed was arranging for follow-up after providing cessation activities. Tobacco control training,achievement, and availability of tool/equipment could altogether predict 21.6 % of variance in smoking cessation activities of nurses (p<0.01).
It is suggested that community nurses should be trained for smoking cessation techniques and tool as well as equipment related to smoking cessation should beavailable in community health sectors to assure effective cessation services. Work achievement in tobacco control at community level should also be recognized.
Findings from this study could be used to further improve smoking cessation activities of Thai community health nurses.

152

P-S8-10

The Effectiveness of a Clinical Nurse Coordinator in Managing a Smoking Cessation Clinic in a Private International
HospitalThanida KHONGSAMAI, Kanjanee RUKSAKUN
Bumrungrad International Hospital
Correspondence email: thanida@bumrungrad.com
Background: Smoking Cessation is hospital quality of care standards set by Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Tobaccosmoking remains the leading cause of death. Morbidity and mortality are reduced by smoking cessation. Multidisciplinary team collaboration help smokers tostop smoking in hospital.
Purpose: studying effectiveness of a clinical nurse coordinator (smoking cessation) manage in smoking cessation clinic
Study Setting: Bumrungrad International Hospital in Bangkok
Method: During the study, a total of 352 patients who attended at least 1 intensive counseling by a clinical nurse coordinator from January 2009 – September
2011 were subjects. The patients had referrals from physicians, clinical nurse coordinators for each specific disease (diabetes mellitus, stroke, heart disease,
hypertension, CKD) and registered nurses in both inpatient and outpatient settings, as well as walk in clients. Clinical nurse coordinators who manage theclinic were trained in smoking cessation and developed a motivation program for smoking cessation. If patients need pharmacotherapy (NRT, Bupropion and
Varenicline), patients were refered to a physician for a prescription. The clinical nurse coordinator evaluated the outcomes for this study, which included an
abstinence rate up to 1 year, a self-reported smoking status and checking carbon monoxide levels. Subject lost to follow up were assumed to be smoking.
Result: Subjects reduced smoking by 22 % and stopped smoking by 38 %. Subjects who used pharmacotherapy did not report statically significant higher
abstinence rates than without (42% and 58 % respectively) at 1 year (P < 0.05). Reasons to quit smoking included: concerns for health (42%), disease (46%) andfamily request (12%).
Conclusion: As one of the most accessible health care professional and clinical nurse coordinator help patient to stop smoking by provide education on theharmful effect of tobacco use, intensive counseling and provide tobacco cessation service.

P-S8-11

Thai Nurses and Tobacco Control : Sharing Experiences

Orasa PANPAKDEE1, Supani SENADISAI2
Ramathibodi Hospital, Mahidol university1, The Nurses Network on Tobacco Control of Thailand2
The Nurses Network on Tobacco Control of Thailand, The Nurses Association of Thailand has received budget supports from Thai Health Promotion Foundation
since 2005 to continuously aim to promote nurses’ awareness of their roles on tobacco control by develop nurse leaders in promoting tobacco free hospitals,
helping smokers quit smoking, developing tobacco free communities, enforcing tobacco free in nursing school, and integrating tobacco control to baccalaureate
nursing education. This presentation aimed to sharing experience in the process of knowledge management in tobacco control for nurses.
Method: Committee of the Nurse Network on Tobacco Control of Thailand organized the conference for sharing success story of tobacco control in each year.
Nurses, nursing faculty members, and nursing students who received grants from the Nurses Network run projects of tobacco control, and attended the conference
in order to present the outcomes. Activities of the conference were composed of: oral presentation of the progress of tobacco control; panel discussion amonggroups of conducting tobacco control in hospitals, communities, and schools of nursing; exhibitions and poster presentations; giving certificates to nurses who
had outstanding projects in tobacco control. In addition, the database of nurses who have been members of the Nurse Network on Tobacco Control of Thailand
was developed.
Outcomes
1. Having and distributing two booklets of learning experiences: nurses and tobacco control provide examples of the practice of tobacco control in hospital,
community, and school of nursing.
2. Multi-media for tobacco control campaigns were produced by faculty members, nursing student , and nurses
3. Ten thousand nurses and fifteen thousand nursing students become a member of the network.
4. Twenty-five nursing research of tobacco control were published in the Thai Journal of Nursing.
In sum, organizing the nursing conference for sharing learning experiences to help smokers quit smoking and promote family and society free from tobacco
use has created body of knowledge and practice guideline to help expand work of tobacco control, to promoting family and society free from tobacco use, andto strengthen nurses’ role.

P-S8-12

Health Systems Model for the Promotion of Smoke-Free Homes

Florante E. TRINIDAD1, Cecilia B. SANTOS2World Health Organization Office1, Philippine League of Government and Private Midwives, Inc.2
A model that would support the Department of Health to promote smoke-free homes was developed by the Philippine League of Government and Private
Midwives with the following objectives:
1. To enhance the knowledge and adequate understanding of men and women on the harmful effects of tobacco and second-hand smoke;
2. To empower wives to persuade husbands to quit and/or smoke outside the home;
3. To build collaboration that establish structures and partners to influence smokers to quit; and4. To ensure that smoke-free homes become a norm in the community.
Training modules to capacitate the Barangay Health Workers in educating family household members in making their homes 100% smoke-free were developed.
Barangay health workers are the target of the training since they are frontline health service providers in the country. Contents of the modules are:
1. Smoking and second-hand smoke
2. Smoke-free home environment
3. Barangay health workers as trainors
4. Communication skills
5. Presentation skills
6. Managing a training program
7. Integration
Methodology includes lectures, participative discussion, simulation/role play and workshops.
Evaluation done of the training conducted yielded favorable results. The training equipped the participants primarily with tools that will give them confidence inproviding brief advise to smokers to stop smoking or to smoke outside the homes.

153

P-S8-13

Roles of Thai Nurses in Tobacco Control

Supanee SENADISAI1, Surintorn KALAMPAKORN2
Thai Nursing Council1, Mahidol University2
The objective of this study was to examine factors influencing tobacco control activities of nurses in Thailand. The sample was 654 nurses working at all levelof health care facilities in Thailand selected by stratified random sampling method. The instrument used in this study was the self-administered questionnaire
consisted of personal factors, motivation, work environment, organizational factors and tobacco control activities. Instrument was examined by experts toassure its content validity and reliability values were between 0.81-0.90. A questionnaire was mailed to the 893 sample of registered nurses for data collection,
654 responded (72.3%). Data were analyzed using descriptive statistic, Pearson’s Product Moment Correlation Coefficient, and Stepwise Multiple Regression
analysis.
Results showed that most of sample had the tobacco control at a moderate level (74.5%). Motivation, organizational factors, tobacco control training, and typeof workplace could altogether predict 41.0 % of variance in the tobacco control activities of Thai nurses (p<0.01).
It is suggested that administrators especially in tertiary care should motivate nurses to work as well as encourage the development of skills and knowledge related
to tobacco control. Findings from this study could be used to further improve tobacco control activities of Thai nurses.

P-S8-14

A Comparison Study on Physician Survey 2003 and 2010 in Yogyakarta, Indonesia: Do the Primary Health Care Doctors
Assess and Advice more on Smoking Habit?

Yayi S. PRABANDARI, Arika DEWI
Universitas Gadjah Mada
Background: Along with the opening of smoking cessation clinic in Yogyakarta in the year 2003 in all lung clinics, several training on brief intervention on
smoking cessation have been carried out. Subsequently, more training were delivered toward Primary Health Care (PHC) doctors after the Yogyakarta Health
Office has opened smoking cessation clinic at primary health care in 2009.
Objective: To assess the comparison between the prevalence of PHC doctors who ask patients about smoking habit and advice their patients to stop smoking in
Yogyakarta municipality in the year of 2003 and 2010.
Method: We used two cross sectional studies conducted in the year 2003 and 2010. The total number of doctors who participated in this study was 224
physicians in 2003 survey taken from total population and 57 physicians in 2010, selected by cluster random sampling. Data was collected by self-administeredquestionnaire
Results:.The percentage PHC doctors who most always and always ask about smoking habits in 2010 survey was higher (42.1 % & 15.8%) than PHC doctors
in 2003 (32.9% & 9.8%) respectively. All PHC doctors in 2010 gave advice to the patients to stop smoking, while there was remain 15.9% PHC doctors in 2003
did not deliver stop smoking advice toward their patients. Half of PHC doctors reported that they have had capacity to help patients stop smoking in 2010 survey,
while only 10% of PHC doctors in 2003 survey said so.
Conclusion: This study reveals that the majority of PHC doctors have delivered advice to their patient. Continuing medical education on the update of the effectof cigarette smoking on health and enhancing skills to help patients quit smoking is needed.
Keywords: physician, patient assessment and advice, PHC

P-S8-15

National Survey on Smoke – Free Primary Care Centers in Thailand

Pongsri SRIMORAGOT
Mahidol University
The aims were to explored smoke-free status in primary care centers, described smoking status among health care workers, health volunteers and people incommunities. In addition, needs assessment of primary care staff for implementing and enforcing tobacco free community. By applying self-reported questionnaireand cross sectional survey design. All 278 primary care centers were simple random sampling from 1,001 primary care hospitals. Data were processed andanalyzed by mean, standard deviation, frequency and percentage. The results revealed that majority of information came from North Eastern primary care centersand follow by the central and northern region. Majority of staff in primary care center were public health staff 31.64% and nurse 18.77 %. Majority of regular
smoker were physical therapist 76.92%, public health workers 11.90% and public health staff 2.71%. Community networks included health promotion and healthvolunteers. Among these staff, they were smoker from 3.43 to 0.27%, respectively. Basic smoking prevalence among primary care staff was shown only 11.6%
and about 30.33 % in community member. Tobacco control policies were implemented and enforced at average level (mean 2.73;SD 2.09) However lower than
average was assigned responsible staff to take tobacco control into action (mean 1.87; SD 1.84) More than half of primary care director were smoke free model(mean 3.80; SD 1.25). For code of health professional practice on tobacco control support, majority of staffs were achieved at high level (mean 4.38; SD 1.16).
For tobacco control action last year majority of center prohibited for tobacco sale and enforced for public smoke free workplace100%. For human resources
development on tobacco control, they needed only general or basic course training 55.9%. Cessation and counseling skill training for staff were done only 45.445.5%. Based on 5As cessation framework they were possible implemented only ask (A1) and advise (A2) 68.6, 64.6 %, respectively. Cessation assisting wasapplied only 68.9%. Less than half (42.15%) were arrange follow up and try to integrate with home visit by health volunteers 41.86%. Recommendation humanresource development course ware on tobacco control and cessation are urgently implementation.
Key words: Primary care hospital, smoke – free environment, national survey* Granting supported by Thai Health Professional Alliance against Tobacco and Thai Health Promotion Foundation154

something to put in my mouth for coping with craving, 2: I can get over to endure, 3: I
can hardly continue to quit because of a strong craving), second is the times of craving
occurred per day (0: 0 time/ a day, 1: ≦1 time/ a day, 2: 1~3 time/ a day, 3: ≧4 time/ aday). The scoring of the TCI is presented in the Figure 1. We obtained this score from

P-S9-01

1,011 patients who received SCT in 6 hospitals between 2008 and 2011. Those who

succeeded
to stop smoking
theSmoking
end of the SCT(at least 4inweeks
of continuous
A “Tobacco Craving Index” is a Useful Indicator
to Predict
Successatof
Cessation
Settings
of Smoking
Cessation Therapy
cessation) showed significant decrease of mean TCI score, whereas less decrease was

Hideo TANAKA1, Chie TANIGUCHI2, Isao OZE1, Hideo SAKA2 evident in patients who failed to stop smoking (Figure 2). In multivariate logistic
regression analysis, TCI through
Aichi Cancer Center Research Institute1, National Hospital Organization
Nagoya Medical Center2 the SCT showed significantly associated with successof stop smoking at the end of SCT. These finding demonstrates that TSI is a usefulTimes of craving occurred per day

To clarify association between craving against smoking and success of
smoking cessation in patients who received smoking cessation therapy (SCT) in Japan,
indicator to predict smoking cessation therapy in Japan.
we provided “Tobacco Craving Index (TCI)”. The TCI consists of the following two axis; one is a strength of craving (0: I feel no craving for smoking anymore,
1: I feel a need for something to put in my mouth for coping
Figure 2.
Figure 1. Tobacco Craving Index (TCI)
with craving, 2: I can get over to endure, 3: I can hardly
Factors associated with weight gain in Japanese smokers
whoofreceived
smoking
cessationtherapy.
ChangeTCI according
to smoking
statusin the SCT
continue to quit because of a strong craving), second is the0: I feel no craving for smoking anymore
1: I feel a need for something to put in my mouth
times of craving occurred per day (0: 0 time/ a day, 1: ≦1
1, Hideo Tanaka2, Syouko Andou1, Mihoko
1, Ayumi
for copingwith craving
Those
who succeeded
to stopKoguresmoking 1,
OthersChie
Taniguchi
Sugishita
Strength of craving
time/ a day, 2: 1~3 time/ a day, 3: ≧4 time/ a day). The
2: I can get over to endure
at the end of the SCT
3: I can hardly continue to quit
Isao Oze2, Hideo Saka1
scoring of the TCI is presented in the Figure 1. We obtained
because of a strong craving
3
1. National Hospital Organization Nagoya
Medical Center
2.41
this score from 1,011 patients who received SCT in 6
0: 0 time/ a day
1: ≦1 time/ a day
Times of craving
2.5
2. time/
Aichi
Caner Center Research Instituteoccurred per day
2: 1~3 time/ a day
3: ≧4
a day
hospitals between 2008 and 2011. Those who succeeded to
1.93
1.86
2
1.60
1.60
stop smoking at the end of the SCT (at least 4 weeks of
2.19
Strength of craving
1.5 gain after quitting, we observed weight
To identify factors associated with risk of weightcontinuous cessation) showed significant decrease of mean
1.56
change in smokers who received Japanese smoking cessation
therapy (SCT) between
the first visit of1
TCI score, whereas less decrease was evident in patients
1.19
0
1
2
3
Grade0
Grade10.97 who
SCT and 12 months after terminationof SCT in 6 Japanesehospitals. Among 447 participants
who failed to stop smoking (Figure 2). In multivariate
0.5
0.77
0 G0received at least 4 times in five sessions of SCT, 283 replied follow-up for 3, 6, 12 months after thelogistic regression analysis, TCI through the SCT showed
NothingWeak0secondthird
fourthfifth
1
G1 G1 of SCT
G2 to obtain body weight and smoking statusfirsttermination
using mail-based
self-reported
significantly associated with success of stop smoking at the
visit
visit
visit
visit
visit
Grade2
Grade3end of SCT. These finding demonstrates that TSI is a usefulquestionnaire.
change of body weight from baseline to the termination of SCT was 1.38kg
2
G1 G2 Average
G3
Moderate
Strongindicator to predict smoking cessation therapy in Japan.
(SD:2.57)G2
in males3
G1
G3 and 1.22kg (SD: 2.09) in females. Figure1 shows the change of body weight frombaseline through 2nd and 5th in the SCT, and 3, 6, 12 months after the termination of SCT. We

subsequently performed a step-wise logistic regression analysis with weight gain of +3.5kg at 12

P-S9-02

months after the end of SCT. Age 50 and over (0.38, 95%CI: 0.19-0.76) and varenicline use (0.30,
Factors Associated with Weight Gain in Japanese Smokers
Who Received Smoking Cessation Therapy

95%CI: 0.11-0.78) were significantly associated with low risk of weight gain (Table 1). Present illness111
Chie TANIGUCHI1, Hideo TANAKA2, Syouko ANDOU1, Mihoko SUGISHITA, Ayumi
KOGURE, IsaoHideo(presence:
3.33, 95%CI:
1.10-10.00),
HighOZEFTND2,score(≧7)SAKA
at baseline(2.07, 95%CI: 1.09-3.92) and1
2months after the end of SCT (4.57, 95%CI: 1.94-10.08) weresuccessofquit
smokingat
12
National Hospital Organization Nagoya Medical Center , Aichi Cancer Center Research Institutesignificantly associated with high risk of weight gain (Table 1). Farther studies are needed to

To identify factors associated with risk of weight gain after quitting, we observed
weight change in smokers who received Japanese smoking cessation therapy
validate these associations and elucidate the other factors for the risk assessment of weight gain in(SCT) between the first visit of SCT and 12 months after termination of SCTsmoking
in 6 Japanesehospitals. Among 447 participants who received at least 4 times in fiveintervention among Asian population.
sessions of SCT, 283 replied follow-up for 3, 6, 12 months after the
Table 1. Factors associated with increasing body weight of +3.5kg
termination of SCT to obtain body weight and smoking status using
and over from baseline to 12 months after termination of smoking
cessation therapy.
mail-based self-reported questionnaire. Average change of body
Odds Ratio p-value[ 95% CI ]Figure1.
Changeofbodyweightbetweenbaselineand12monthsafter
theweight from baseline to the termination of SCT was 1.38kg (SD:termination of smoking cessation therapy among study subjects. (n=283)
Age
1.00
＜50
2.57) in males and 1.22kg (SD: 2.09) in females. Figure1 shows the
0.38
0.006
[0.19-0.76]≧50change of body weight from baseline through 2nd and 5th in the SCT,＜-1.5 -1.5kg≦＜+1.5kg +1.5kg≦＜+3.5kg +3.5kg≦＜+5.5kg +5.5kg≦
and 3, 6, 12 months after the termination of SCT. We subsequently
2nd session
Present illness Absence
1.00
3.2
81.4
15.0 0.4(after 2weeks)
3nd session
performed a step-wise logistic regression analysis with weight gain
Presence
3.33
0.032[1.10-10.00]
2.8 1.1
6.7
67.5
21.9
(after 4weeks)
4nd sessionof +3.5kg at 12 months after the end of SCT. Age 50 and over (0.38,
8.8
54.4
6.4 2.8
27.6
FTND
1.00
＜ 7
(after 8weeks)
5th session
95%CI: 0.19-0.76) and varenicline use (0.30, 95%CI: 0.11-0.78)
4.0
12.2
7.2
43.9
32.7
2.07
0.026
[1.09-3.92]≧7(after 12weeks)
were significantly associated with low risk of weight gain (Table 1).
Follow up
Prescription
Nicotine patch
1.00
Present illness (presence: 3.33, 95%CI: 1.10-10.00), High FTND
After 3months
10.6 7.1
15.6
43.0
23.7
Varenicline
0.30
0.014
[0.11-0.78]
score (≧7) at baseline (2.07, 95%CI: 1.09-3.92) and success of quit
After 6months
17.3
13.1 8.8
36.8
24.0
Smoking status Smokers
1.00
smoking at 12 months after the end of SCT (4.57, 95%CI: 1.94After 12months
19.4
36.0
18.7
12.7
13.1
Quitters
4.57
0.001[1.94-10.08]
0%
20%
40%
60%
80%
100%
10.08) were significantly associated with high risk of weight gain
Stepwise logistic regression analysis(Table 1). Farther studies are needed to validate these associations
Explanatory variables : sex, age (>50/ 50≦), present illness (no disease/
have a something disease), BMI (<25/ 25≦), FTND score (<7/ 7≦), theand elucidate the other factors for the risk assessment of weight gain
number of cigarette smoking per day (<30/ 30≦), prescription (Varenicline/
Nicotine patch), nausea (-/ +), craving (negative/ positive), smoking status atin smoking intervention among Asian population.
the 12 months after the last session (smokers/ quitters)

P-S9-03

WERO: An Innovative Group Stop Smoking Competition Designed to Reduce High Smoking Prevalence among Ethnic
Minority and Low Socioeconomic Populations: Main Results

Marewa P. GLOVER1, Nathan J. COWIE1, Chris PATON1, Anette C. KIRA1, Warren MOETARA2
University of Auckland1, Northland District Health Board2
Background: New Zealand is aiming to be smokefree by 2025 (5% or less smoking). Current smoking prevalence is 18% but smoking prevalence for Māori(the indigenous people) and Pacific Island people is high (41% and 26%) and is an important source of health inequalities. Tobacco control strategies to prompt
quitting across all ethnic groups are urgently needed. We designed a 3 month group stop smoking contest. Key features were: 1) group focus; 2) use of existing
cessation services; 3) use of an incentive ($5000 prize for the winning teams’ nominated community group); 4) interactive technology (www.wero.me and mobile
app publicly displays who is in front, and provides access to expert support from WERO staff); 5) inter-group competition; 6) ‘serious gaming’ – a free iPad/
iPhone game Stub It Out as a distraction tool and health education resource.
Research Methodology: A pretest-posttest design was used. Fifteen teams of current daily smokers (N=148) were recruited from community health workers’
networks over a 6 week period. Smoking status at baseline and 3 months was biochemically verified using expired carbon monoxide. Self-reported smoking
status was asked at 6 months.
Results: Forty-six% of Pacific Island, 44% of rural Māori, and 20% of urban Māori participants were verified smokefree at 3 months - an overall quit rate of
36%. Six month posttest results will be presented for the first time at APACT 2013.
Discussion: WERO was effective at prompting quit attempts with underserved populations and provided an innovative vehicle for existing health and cessation
services. WERO can be scaled up and repeated multiple times per year to increase the reach, effectiveness and population impact of cessation. Thus, WERO has
the potential to trigger mass quitting accelerating New Zealand towards its Smokefree 2025 goal.
WERO is supported through funding from the Reducing Tobacco-related Harm Research Partnership co-funded by the Health Research Council of New Zealandand the Ministry of Health of New Zealand (HRC grant 11/818)
Topics: M Cessation / Quitline / Treatment of tobacco dependence
L Education, communication, training and public awarenessKeywords: Group Cessation, Minority Groups, Incentives155

P-S9-04

A Trial of Smoking Cessation Support for Youth Smokers in School Setting

Atsuko AOKI1, Naomi MIKAMOTO2, Nobuhito ISHIKAWA3, Kaoru INOUE4, Takashi DOI1, Daisuke MATSUI3, Isao WATANABE2, Nagato KURIYAMA2,
Masako SHIGETA2, Yoshiyuki WATANABE2
Kyoto Association for Tabacco Control1, Kyoto Prefectual University of Medicine2, Japanese Red Cross Kyoto Daiichi Hospital3, Kyoto Tachibana University4[Background] Smoking among youth is the biggest health problem because of damage to their health both now and in future. However, smoking among youth(<20y.o.) is treated as an offense in most cases in Japan due to The Minor No Smoking Law. Thereby the health problems of smoking have been almost ignored inschool health activities and youth smokers rarely themselves admit to smoking. Consequently youth smokers do not receive information about smoking cessation
and appropriate support in school setting. [Objective](1) To communicate to youth smokers in open and non-patronizing way(2)To collect information about
their smoking status and identify their characteristics (3) To give brief advice about quitting in a way that suits youth (4) To estimate the effects of the support
1 year later [Material and Methods] Kyoto Association for Tobacco Control (KATC) has been conducting tobacco-free workshops at 73 schools (47 junior highschools (JHS), 22 senior high schools (SHS) and 4 part-time high schools (PHS)) for 11,769 students during the 2011 school year. There were 160 students who
voluntarily admitted to smoking (in JHSs; 23, in SHSs; 112 and PHSs; 25). The KATC stuff listened to them frankly and responded youth smokers’ real feeling.
Then the stuff measured CO by smokelyzer and gave advice for smoking cessation briefly and distributed small lucky charms and leaflets. In holiday season,
we sent a card with special candy and hand-made goods to individual students through school nurses. One year after the workshops, we asked their smoking
status to the school nurses.[Result]It was felt that we could communicate with youth smokers in a positive and constructive way. Most of interviewee talked
about their troubling situation and wish to quit. The smokers consisted of 137 boys (85.6%) and 23 girls. The median of starting age was 12.5 and there was nodifference between boys and girls. The mean of the number of cigarettes smoked was 5.5 for JHS students, 9.9 for boys in SHS, 7.7 for girls in SHS, 15.1 forboys in PSH and 9.3 for girls in PHS. The CO levels detected in the breath were over 4ppm in 60% and 10 ppm in 10% of smokers. CO correlated the numberof cigarettes smoked. The school nurses could contact twenty students in SHSs and 11 students in PHS. Nine students (40%) in SHS and 4 students (34%) in
PHS quit smoking.[Discussion] Smoking among high school students tend to be hidden from view in Japan. We could communicate with them smoothly because
we previewed the tobacco issue to school teachers and school nurses as nicotine dependence. Through the trial, we recognized that many youth smokers wishedto quit smoking and their health was harmed seriously. We consider this non-confrontational approach to be as one of the best opportunities to contact youth
smokers and offer support for smoking cessation. [Conclusion] Communication with youth smokers and smoking cessation support in a school setting is bothnecessary and possible. Smoking among youth should not be considered as an offense but as an illness.

P-S9-05

Absence of Pre-operative Smoking Cessation is the Maximum Risk Factor of the Postoperative Complications
Occurrence

Masahiro MORI, Jun KOBAYASHI, Yuichi MORISHIMA, Yasuyoshi TOYODA, Daisuke SATOMI, Yasuko TOSHIMITSU, Yoji TAKAMI,
Satoshi FUKUTOMI, Kaisuke YAMAMOTO, Hiroshi KOMODA
National Hospital Organization Chiba medical center【Background / purpose】Smoking is a risk factor of the post-operative complications, and it is a well-known fact that incidence of complications decreases bypreoperative smoking cessation. However, pre-operative non-smoking instruction is not performed enough for all patients. Kai et al reported in 2008 that only
26% of surgeons and 6% of anesthesiologists performed pre-operative non-smoking instruction. This study was aimed to clarify the risk factors about surgicalcomplications in smokers, in order to spread pre-operative non-smoking instruction to more surgeons.
【Method】All of 201 cases who had a colorectal surgery with elective laparotomy between June 2010 and September 2012 were examined retrospectively. At
first, we divided patients into two groups in having post-operative complications or not, to clarify risk factors of post-operative complications. Their factors were
statistically studied with regard to each of the items, age, gender, target organ, preoperative comorbidity, ASA physical status, %VC, FEV1.0%, anesthesia time,
operation time, amount of bleeding, and smoking history. Then, we divided smokers into two groups in having post-operative complications or not, and compared
the similar items that added pre-operative smoking cessation, to clarify risk factors about post-operative complications for the smoker.
【Results】In the object, 100 patients had smoking history (49.7%) and 101 patients had no smoking history (50.3%). The postoperative complications occurredin 71 cases (35.3%) of all patients. Patients with smoking history were 51 of 71 cases (71.8%). In the group having post-operative complications, smoking
history recognized significant difference (p<0.01). The group having smoking history without pre-operative smoking cessation, showed significantly increased
postoperative complications (p=0.016, Odd ratio=2.67).
【Conclusion】In this study, smoking was shown to be a risk factor of the postoperative complications. And the risk factor of the postoperative complications
for a smoker is absence of preoperative smoking cessation. It is important for surgeons to understand that pre-operative smoking cessation reduce post-operativecomplications. This means that it leads to improvement of safety in peri-operative period.

P-S9-06

J-STOP (Japan Smoking Cessation Training Outreach Project): The Outline and Evaluation

Akira OSHIMA1, Shizuko MASUI2, Masakazu NAKAMURA2
Osaka Medical Center for Cancer and Cardiovascular Diseases1, Osaka Center for Cancer and Cardiovascular Diseases Prevention2
Although in Japan tobacco control implementation lagged behind many countries, smoking cessation treatment, as an exception, has been covered by healthinsurance since 2006. Now, smoking cessation treatment is being provided in about 14,000 medical institutions (25.5% of hospitals and 11.7% of clinics). Two
sample surveys show that about 30% of smokers had continued cessation at the follow-up 9 months after the end of 12 weeks’ treatment. Smoking cessation
counseling will also been fully incorporated into general health checkups covered by health insurance in April, 2013.
Japan Medical-Dental Association for Tobacco Control started J-STOP (Japan Smoking cessation Training Outreach Project) in 2008 to standardize the qualityof smoking cessation treatment and to increase the number of registered medical facilities by providing a training program for physicians and co-medicals. The
training program is based on e-learning system and consists of three versions, i.e., full and basic versions for smoking cessation treatment and a version forsmoking cessation counseling. After a pilot implementation, nation-wide implementation started in 2010. About 2,000 health professionals participated in the
J-STOP e-learning course between 2010 and 2011.
Effectiveness of the three versions of the training on the trainees’ knowledge, attitudes, self-efficacy, and behaviors concerning smoking cessation were assessedby comparing the score before and after the training using a structured self-administered questionnaire. The results show that the training program improved thetrainees’ knowledge, attitudes, self-efficacy, and behaviors concerning smoking cessation. The details will be presented.

156

P-S9-07

Factors Associated with Smoking Cessation among Bangladeshi Adults: Findings from ITC Bangladesh Survey

Abu S. ABDULLAH1,2, Pete DRIEZEN3, Anne C. K. QUAH3, Nigar NARGIS4, Geoffrey T. FONG3,5
Boston University School of Medicine1, Guangxi Medical University2, University of Waterloo3, University of Dhaka4, Ontario Institute for Cancer Research5
Objective: To examine the factors associated with smoking cessation behavior (that is, quit attempts and smoking cessation) among a representative sample of
Bangladeshi adults.
Methods: Data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control (ITC) Survey in Bangladesh, a face-to-face survey of adult smokers,
were analysed. Households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Respondents included in the study
are 1802 adult daily smokers (cigarette only or dual use of cigarette and bidi) in the Wave 1 survey who completed the Wave 2 follow up.
Results: Of the smokers (N=1802), 98% were male, 18% were illiterate, 78% were married and 39% were aged 40 or above; 93% were cigarette smokers and
7% were dual users (cigarette and bidi). Overall, 25.8% of the baseline smokers made quit attempts (that is, daily smokers who made at least one quit attemptthat lasted for at least 24 hours) during the 11 to 12 months between Waves 1 and 2 Only 4.4% quit successfully (that is, daily smokers who had stopped smoking
for at least 6 months at the time of the Wave 2 survey). A higher proportion of men (74.3%) who were daily smokers in Wave 1 did not try to quit by Wave 2
compared to women (50.7%) (χ2=4.24, df=2, p<0.005). A significantly greater proportion of older (aged 40 or above) smokers tried to quit and quit successfully(63% versus 27%, χ2=33.2, df=8, p<0.0001). A smaller proportion of students (57%) did not try to quit smoking compared to other occupational groups (above70%) (χ2=25.1, df=12, p=0.015). Quitting smoking was not associated with the type of cigarette smoked (exclusive versus dual users) and number of cigarettesmoked daily.
Conclusion: Among Bangladeshi smokers, different factors were associated with making a quit attempt or being successful in their quit attempt. Populationbased smoking cessation programs should take these factors into consideration in the design of smoking cessation interventions. At the same time, measures arenecessary to encourage more daily smokers to take quit attempts.

P-S9-08

The Way to Find “Hidden” Smokers’ Wish

Takahiro SHIMIZU1, Hiroshi YAMASHIRO1,2
Social Medical Corporation Keiaikai1, Okinawa University2
Background: Essentially, cigarette smoking may be considered a disease known as nicotine dependence. However, some Japanese believe otherwise, despite thisnotion being a universal truth. Many of them assume that they may successfully quit smoking on their own, although in reality, smoking cessation is difficult toachieve without medical intervention. Ningen-Dock is an excellent health examination system that is widely used in Japan. We attempted to identify the smokers
who are interested in quitting smoking despite n the Ningen-Dock checkup.
Object: A total of 2,319 current smokers (male 1796, female 523), who undertook the Ningen-Dock health check program from April 1, 2011 to March 31,
2012, were included in the study.
Methods: We used a smoking questionnaire that can be read by our optical character reader (OCR) system. Adopting Nakamura’s stage model, we requested
patients to choose their level of willingness to quit smoking. Additionally, we provided options about the factors that influence their willingness to use medication
for smoking cessation. The options about medication included (1) sill never use, (2) will use if rewarded, (3) will use if medication is free, (4) will use if
medication is cheaper than tobacco, and (5) will use even if expensive. All data were analyzed using the Spearman analysis with SPSS.
Results: The majority of the smokers who were interested in quitting smoking were significantly likely to immediately chose option 5 (will use even if
expensive). Answers to the questions showed positive correlations with Nakamura’s stage-model. Surprisingly, those who were not interested in quitting smoking
also chose option 5 among others.
Discussion: We make two conclusions from the study. First, smokers who are interested in quitting smoking are willing to receive medical intervention. Second,smokers who are not interested in quitting smoking are also willing to receive medical intervention, but with low probability. It is therefore possible to identify
smokers who are interested in quitting smoking despite non-declaration in the Ningen-Dock checkup.

P-S9-09

Exercise Helps Smokers to Quit Smoking, to Remain Smoke-free and to Reduce the Risk of Death

Chi-Pang WEN, Wayne KAO, Min-Kuang TSAI, Shiuan Be WU
National Health Research Institutes, China Medical University Hospital, GLOBALink
Background and aims: Much of the attention on tobacco harm reduction has been on modifying the product, but the extent of modifying physical activity ofsmokers in reducing the harm is less known. The objectives of this study are to find out whether becoming physically active could reduce the smoking hazards,
and if so, the extent of benefits in each of the smoking related diseases. Methods: In
this prospective cohort study, 429,244 individuals (47.9% men) went through standard
medical screening program(s) from 1996 to 2008, with an average follow up of 8.05
(SD: 4.21) years. The exercise volume of each individual, expressed in MET·hour/
week, was placed into inactive (<3.75), low-active (3.75-7.49), or active (≥7.50)
category. Hazard ratios (HR) for cardio-vascular disease (CVD) mortality, adjusted
for 10 confounders, were calculated. Results: Smokers were found to exercise less(22.9%) than ex-smokers (37.4%) and non-smokers (24.2%). When compared toinactive smokers, low-active or active smokers had significantly lower CVD mortality
risk, 0.85 (0.68~1.06) and 0.66 (0.54-0.79) respectively. If smokers quit, their allcause mortality risks further decreased to 0.53 (0.43-0.66) for active ex-smokers. For
ischemic heart disease and stroke mortality, physical activity and quit smoking canalso significantly lower the mortality risk. Conclusions: Physical activity reduced
mortality risks of smokers for CVD, including ischemic heart disease and stroke, by
34%, by 48% and by 27%, respectively, in contrast to quitting smoking by ex-smokers,
47%, 49% and 51%. In addition, increasing exercise made smokers more likely to quit,
resulting in ex-smokers, with a major reduction in mortality.

157

P-S9-10

Enhancing Dental Tobacco Intervention under the Universal Health Insurance System in Japan

Takashi HANIOKA1, Miki OJIMA2
Fukuoka Dental College1, Osaka University2
Background and aim. Dentists are ideally placed to promote quitting by explaining the impact of tobacco use on oral health. Consequently, smoking-related
fatal diseases can be prevented in addition to dental diseases. However, dental tobacco intervention practices were limited or restricted, and dental professionals
have not fully embraced opportunities for tobacco intervention. In Japan, the universal health insurance system does not cover such preventive service as dental
tobacco interventions. To enhance dental tobacco interventions, we analyzed records from three previous studies conducted in dental clinics on the bases ofdental tobacco intervention for prevention of progression of dental diseases and improvement of the effects of dental treatments that have potential coverage ofthe universal health insurance system.
Methods. The three previous studies were conducted in 35, 739, and 106 dental clinics in Japan in 2004 (Study I), 2008 (Study II), and 2010 (Study III),
respectively. The study protocols were approved by the Ethics Committee of Fukuoka Dental College. In the Study I, patients were briefly provided feedback
involving the presentation of oral health effects personally relevant to smoking utilizing a color chart consisting of graphics with messages about prevention
and dental treatments, and the stages of behavior change were recorded. In the Study II, two kind of color charts with the orientations of prevention and dental
treatments were provided randomly to dentists. In the Study III, dentists and dental patients were asked about dental tobacco interventions regarding prevention
and dental treatments.
Results. The topic of the effects of smoking cessation, including those on dental treatments, and premature tooth loss, including those on prosthetic treatments,
had high potential for motivating force for both personal and public aspects (Study I). More dentists who used treatment-oriented color chart intended to continue
the intervention than the counterparts (Study II). More dental patients were receptive to the intervention for prevention than dental treatments, while more dentists
were interested in the intervention for dental treatments than prevention (Study III).
Conclusions. Together with the previous reports of lack of reimbursement as a significant barrier, these results indicate importance of the effects of dental
tobacco interventions on the progression of dental diseases and dental treatments in Japan.

P-S9-11

Capacity Building in Smoking Cessation – Singapore’s Experience

Sarita DEVI, Sultana Abdul LATIFF, Amrita NAMASIVAYAM, Chang Yin WUAN, Chris CHEAH, Annie LING
Health Promotion Board
Background: Singapore has one of the lowest smoking prevalences in the Asia Pacific region at 14.3% in 2010. To further denormalise tobacco use, the Health
Promotion Board (HPB) has adopted a whole-of-government approach to provide a conducive environment for smokers to quit smoking. HPB actively engages
the 3Ps (Public, Private, People sectors) to create and impact multiple touchpoints in various community, workplace and healthcare settings.
As more smokers are encouraged to quit smoking, it is important to ensure that cessation services are easily accessible. Therefore, beyond policies and programmeinterventions, HPB is focusing on capacity building to train service providers in smoking cessation.
Intervention and Findings: Beyond HPB’s QuitLine (a toll-free number staffed by trained nurses who administer phone counselling to smokers) and theexisting network of healthcare professionals providing smoking cessation services in the community, there is a need to continuously expand this pool due tothe increase in demand for cessation services as a result of aggressive public education and interventions. As such, HPB introduced a training and certification
process in 2005 for health care professionals to be certified as Quit Consultants.. To date, 450 have gone through the training, and 58% have attained Certificate
for Quit Smoking Consultants (CQSC) certification.
In addition, volunteers known as Health Ambassadors (HA) have also been equipped with the knowledge and skills to help smokers through a structured training
process since 2012. Selected HAs have been trained as Quit Buddies to work with smokers via QuitLine, or be trained further to become Quit Consultants under
the CQSC certification process. To date, 70 HAs have enrolled in the training, and will be assessed before they are attached with QuitLine. They will join the
network of support in the community to give advice to smokers and link them up with existing smoking cessation services.
Results: The efforts of the Quit consultants and HAs, in tandem with other smoking cessation programmes have seen a threefold increase in the number ofsmokers seeking help, from 1,725 in 2010 to 4,869 in 2012, and a corresponding 30% quit rate through HPB’s QuitLine, community pharmacies and healthcare
partners. HPB aims to build up a robust cessation network in the community to increase the accessibility of smoking cessation services as an important step
towards denormalising smoking in Singapore.

P-S9-12

Readiness to Quit Smoking among People Living with HIV/AIDS (PLWHA) in the Kathmandu Valley, Nepal: Knowledgeof Tobacco-related Health Risks is not Enough

Rachel M. AMIYA1, Krishna C. POUDEL2, Kalpana POUDEL-TANDUKAR3, Jun KOBAYASHI4, Basu D. PANDEY5, Sushil KHATRI6, Masamine JIMBA1The University of Tokyo1, University of Massachusetts Amherst2, Waseda University3, Bureau of International Cooperation4, Sukraraj Tropical and Infectious
Disease Hospital5, Youth Vision6
Background: Tobacco smoking is highly prevalent (41-66%) and uniquely harmful among people living with HIV/AIDS (PLWHA). PLWHA who smoke are
more vulnerable to opportunistic infection and less responsive to antiretroviral therapy. We thus sought to assess HIV-specific knowledge about smoking, and its
association with readiness to quit among HIV-positive smokers in the Kathmandu Valley of Nepal, one of South Asia’s least developed countries.
Methods: In this cross-sectional study, we surveyed a community-based sample of 151 adult PLWHA who were current smokers residing in the Kathmandu
Valley, Nepal. Participants were recruited through purposive, convenience sampling techniques and interviewed using a structured, pre-tested Nepali language
questionnaire. Data were analyzed using multiple logistic regression to examine associations between agreement with smoking-related knowledge statements
and readiness to quit smoking (stage of behavior change).
Results: Of 151 current smokers, 34% were thinking seriously of quitting within the next 6 months (contemplation or preparation stage of change). Overall,
74% understood that quitting smoking was still beneficial even after smoking “a pack of cigarettes a day for more than 20 years”; 85% correctly linked smoking
with elevated risk of heart attack; 94% correctly linked smoking with elevated risk of lung cancer; 83% recognized smoking as an immediate and “serious healthconcern for HIV-positive people”; and 81% recognized that smoking is “more dangerous for HIV-positive individuals than it is to people without HIV”. However,none of these measures of smoking-related knowledge showed a significant association with quitting readiness.
Conclusions: In this group of HIV-positive smokers residing in Nepal’s Kathmandu Valley, levels of knowledge on HIV-specific smoking-related harms and thebenefits of smoking cessation were high and unrelated to quitting readiness. This context suggests that future efforts to combat smoking among PLWHA should
focus on promoting cessation through proven behavioral and pharmacological approaches, rather than didactic education on harms.

158

P-S9-13

Varenicline Versus Transdermal Nicotine Patch : A 3-year Follow up in Smoking Cessation Clinic in Taiwan

Kuang-Chieh HSUEH, Ming-Yueh CHOU, Lee-Fei PAN, Ming-Shium TU
John Tung Foundation
Rationale
A network meta-analysis of randomized trials and real-world comparative studies strongly suggest that varenicline is more effective in aiding smoking cessation
than single form nicotine replacement therapy. Modeling the health benefits attributable to this difference relies on extrapolation to lifetime cessation but to datefollow-up has only extended to 12 months. Longer term follow-up data are helpful in checking these assumptions.
Objectives
This study aimed to compare the sustained abstinence rates of smokers using varenicline versus nicotine patch in their quit attempt up to 36 months.
MethodA total of 587 smokers were recruited via the Department of Family Medicine outpatient department at Kaohsiung Veteran General Hospital between Feb 2006
and Aug 2009. Participants received counseling from a physician and chose either varenicline (N=296) or the nicotine patch (N=291) for smoking cessation.
Both varenicline and nicotine patch users could receive their medications for maximum 8 weeks prescription and 8 clinic visits in 90 days. Participants were
followed-up by telephone at 3, 6, 12 and 36 months from first visit. The primary outcome was self-reported sustained abstinence.
Results
Multiple regression of 36-month sustained abstinence on to medication choice adjusting for other baseline variables showed a significant advantage for varenicline,
OR= 2.88 (95% CI 1.64-5.05). The relapse rate from 3 months to 36 months was non-significantly higher in the NRT group than the vareniclien group.
Conclusion
Varenicline appears to yield higher abstinence rate out to 3 years than nicotine patch in a smokers clinic where smokers can choose their medication option.

P-S9-14

Current Smoking Rate in Patients with Psychiatric Disorders in Japan: Questionnaire Survey

Wakako NAKANO1, Kenji HAYASHI1, Chiharu YOSHII2, Jun NAKAMURA1
University of Occupational and Environmental Health1, Wakamatsu Hospital of University of Occupational and Environmental Health2
Background: Patients with psychiatric disorders (PD) are two to three times more likely to smoke than patients without PD. The association between smoking
and PD has been known for many years. Support for smoking cessation among patients with PD in provided in advanced nations, but there is little support forsmoking cessation among patients with PD in Japan, and few studies have investigated the smoking rate in Japan. The aim of the present study is to determine
the smoking rate and smoking habits among Japanese patients with PD.
Methods: The subjects included outpatients who visited the outpatient psychiatric clinic at the University of Occupational and Environmental Health hospital
between January 5th and March 31st of 2011. The questionnaire consists of questions about the sociodemographic background and smoking habits of the patients.
Results: We administered the questionnaire to 1,279 outpatients during the period of the study, and 1,242 responses were returned, for a survey response rateof 97.1%. We analyzed 733 subjects, the overall smoking rate was 25.1%. The smoking rate among the patients with schizophrenia and depression was 17.3%
and 23.9% respectively. Among the current smokers, 43.4% had experienced smoking cessation, and of the current smokers, only 26.1% were not interested insmoking cessation. Of the current smokers, 37.5% spent between 10,000 and 20,000 Japanese yen per month (US$128 and US$257) on cigarettes.
Conclusions: The smoking rate among the Japanese PD patients was not high in this study, and further large nationwide studies are needed in Japan.

P-S9-15

Outcome of Smoking Cessation Therapy for Nicotine Dependents with Psychiatric Disorders in Japan

Wakako NAKANO1, Kenji HAYASHI1, Chiharu YOSHII2, Jun NAKAMURA1
University of Occupational and Environmental Health1, Wakamatsu Hospital of the University of Occupational and Environmental Health2
Object: The smoking rate is high and the success of smoking cessation is low among psychiatric patients. In this study, we present the outcome of smoking
cessation for nicotine dependent patients with psychiatric disorders.
Method: The subjects were 56 outpatients (male, 20; female, 36; mean age, 41.1 ± 11.7 years) who visited our smoking cessation clinic and were treated forsmoking cessation under the terms of the health insurance system. The kinds of diagnoses were: affective disorder, 28; schizophrenia, 11; alcohol dependency,
5; personality disorder, 2; and others, 10. We compared age, amount of smoking per day, age at first smoking, BI, number of experiences of smoking cessation,
the Tobacco Dependence Screener Scale, the Fagerström Test for Nicotine Dependence, the Kano Test for Social Nicotine Dependence, and success or not at theend of 12 weeks treatment.
Results: The smoking cessation rate was 37.5%. The only significant difference was CO level at 12 weeks (successful: 1.8 ± 1.6 ppm; unsuccessful: 12.8 ± 12.4
ppm, p ＝0.002). The CO levels at 4 weeks were below 7 ppm among the successful patients. There was no significant difference in smoking rate between thesmoking cessation drugs (nicotine patch, 31.6%; varenicline, 40.5%; p＝0.512).
Discussion: There were many patients who had stopped the treatment before the end, so more frequent treatment for psychiatric patients is important.
Conclusion: Patients with psychiatric disorders can stop smoking, and we would like to investigate long-term outcomes in the future.

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P-S9-16

Evaluation of One-year Outcome of Smoking Cessation among Patients who Successfully Finished a 12-week Smoking
Cessation Program

Chiharu YOSHII1, Fumio KUNITOMO2, Masato KANO3, Chinatsu NISHIDA4, Yukiko KAWANAMI4, Hiroshi MUKAE4
Wakamatsu Hospital of University of Occupational and Environmental Health1, Chiba Rosai Hospital2, Shin-nakagawa Hospital3, University of Occupational
and Environmental Health4
Background: In order to evaluate psychological nicotine dependence among smokers, we have been using the “Kano Test for Social Nicotine Dependence(KTSND)” which has 10 questions with a total score of 30. In addition, we started to use the “Release from Tobacco (RT)” index at the end of smoking cessation
clinic. RT index consists of only 2 questions, 1) Do you still want to smoke? 2) Do you still envy smokers? RT positive means those who don’t want to smoke
anymore and don’t envy smokers, and RT negative means those who still want to smoke and/or envy smokers. The purpose of this study is to find factors thatcan predict the abstinence of smoking.
Methods: Ninety-six patients successfully finished a 12-week smoking cessation program between August 2008 and March 2011. At the beginning of the
program, they answered smoking history (pack-year), Tobacco Dependence Screener (TDS), Fagerström Test for Nicotine Dependence (FTND), and KTSND.
Then they also answered KTSND and RT index at the end of the 12-week program. We asked them about the one-year outcome of smoking cessation by postal
documents or through telephone interviews, and 89 patients replied. Among them, 59 patients (66.3%) continued the abstinence of smoking and 30 (33.7%)
turned to relapse smoking. We compared these two groups (Abstinence group vs. Relapse group) with regard to the factors of abstinence.
Results: There was no significant difference in gender, pack-year, TDS, FTND, KTSND (1st and 12th week), medication (nicotine patch or varenicline), andprevalence of underlying diseases between the two groups. However patients in older age (55.7 ± 13.2 vs. 50.0 ± 13.4, p < 0.05), fewer comorbid psychiatricdiseases (7.3% vs. 42.9%, p < 0.01), and positive for RT (69.5% vs. 33.3%, p < 0.01) tended to continue abstinence.
Conclusion: From the results, one third of the patients who successfully finished 12-week smoking cessation program relapsed smoking within one year. Although
the relapsing rate is not high compared with previous reports, evaluation by RT index is very simple and an easy way to assess the patient’s psychological aspectsof smoking cessation.

P-S9-17

New Zealand’s Tobacco Control Research Tūranga: Accelerating Progress towards Smokefree New Zealand by 2025

Marewa P GLOVER, Chris R BULLEN
University of Auckland
Background: New Zealand’s goal is to reduce tobacco smoking prevalence to less than 5% by 2025. With 650,000 smokers and widening ethnic andsocioeconomic disparities in prevalence, innovative interventions are urgently needed. Smoking prevalence among the indigenous Māori is 41% and NZ resident
Pacific Island people 26%. In 2010, the NZ Ministry of Health and Health Research Council established the Tobacco Control Research Tūranga (Māori for‘platform’) to identify strategies to halve smoking prevalence by 2020. Representing a radical shift in how research funding has traditionally been allocated,
the Tūranga was given full discretion to spend $5 million/4yrs as their programme unfolded. Method: 23 leading researchers over 9 institutions plus 29
collaborators formed the Tūranga. Four initial projects were supported by the funding committee. The Tūranga then established a Scholarship Fund and an
Emerging Issues Fund, open to any student/researcher in NZ. Annually a priorities exercise is conducted to identify breakthrough projects which are developed
into a purchasing plan reviewed by national advisors and key stakeholders. Results: Several projects have been completed or are underway and are grouped
into five broad themes. Tobacco Control Policy: 1) analysis of international trade and investment agreements that could scuttle NZ’s endgame strategies; 2)
modelling of a ‘sinking lid’ (quota management) system for phasing out the import and sale of tobacco products. Nicotine Studies: 1) a short-term randomised
control trial determining if a price differential based on nicotine content reduces cigarette consumption. Māori and Pacific Tobacco Control: 1) a group stopsmoking competition to encourage mass quitting among priority populations with high smoking prevalence; 2) cessation support delivered via NZ Samoan
radio. Smoking in pregnancy: 1) a feasibility study testing the efficacy of retail voucher and product incentives to help pregnant Māori women stop smoking.
Discussion: Research has an important if not crucial role in progressing endgame strategies to eradicate smoking related death and illness. Dedicated, yet
flexible, funding enables the Tūranga to respond quickly to inform policymakers and the tobacco control sector about breakthrough strategies. In a constrained
funding environment, a logical programme of research with wide sector involvement and support could reduce duplication and increase the focus on pragmatic
information needs and effective intervention design. The new funding model could, if successful, provide a more cost-effective way for Government’s to manage
tobacco control research funding.
Topics: M Cessation / Quitline / Treatment of tobacco dependence
L Education, communication, training and public awarenessKeywords: Research, Research Funding, Banning tobacco

P-S9-18

Smoking Cessation Outcomes among Individuals with a History of Psychotic Disorders as Compared to Those Without

Chizimuzo T. C. OKOLI1, Milan KHARA2
University of Kentucky1, Vancouver Coastal Health Mental Health and Addictions Services2
Background: Psychotic disorders (e.g., Schizophrenia, schizoaffetive disorder) are associated with a higher smoking prevalence (relative to other psychiatricdisorders) and smoking attributable mortality. Until recently, little has been done to address the disproportionate smoking in this population. The objectives ofour study are to: 1) describe the characteristics of smokers with a history of psychiatric disorders (i.e., none, psychotic, and depressive/anxiety) and 2) examine
smoking cessation/reduction outcomes by history of psychiatric disorders.
Methods: Retrospective analyses were conducted from charts of 982 participants accessing a tailored, evidence-based, tobacco treatment program within mental
health and addictions services in Vancouver, Canada. Demographics, tobacco use and cessation attempt history, nicotine dependence, importance and confidence
in quitting smoking, expired carbon monoxide (expCO) level, history of polysubstance use, and total visits to the program were obtained. Main outcomes were:a) 7-day prevalence of smoking abstinence verified by expCO and b) a 50% reduction in baseline cigarette consumption verified by expCO (for those who did
not achieve abstinence).
Results: As compared to individuals with no psychiatric disorder, those with psychotic disorders were more likely to have initiated smoking later, reportlower importance and confidence in quitting, smoke a greater number of cigarettes per day, and be more nicotine dependent. Among program completers(n=543), 35.7% of individuals with a psychotic disorder achieved smoking cessation (as compared to no psychiatric disorder =45.6% vs. depressive/anxiety
disorder=39.6%, p=.350). Similarly, 59.3% of individuals with a psychotic disorder achieved smoking reduction (as compared to no psychiatric disorder=74.1%
vs. vs. depressive/anxiety=67.3%, p=.370) among those who did not achieve abstinence at the end of treatment (n=244). In multivariate analysis, significant
predictors of successful smoking cessation were: a) having a greater number of visits to the program among individuals without a psychiatric disorders, b) having
a lower baseline expCO level among individuals with psychotic disorder, and c) a greater number of visits to the program and a greater length of abstinence atthe last quit attempt among individuals with depressive/anxiety disorders.
Conclusion: Individuals with a history of psychotic disorders are able to achieve smoking cessation when provided evidence-based treatment. However, tailoredapproaches specific to the needs of individuals with psychotic disorders may be warranted to enhance cessation outcomes. Hence, future studies may be required
to further understand how to tailor treatment outcomes and modify existing treatment approaches to optimize outcomes among individuals with a history ofpsychotic disorders and other psychiatric disorders.

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P-S9-19

Efficacy of Foot Reflexology on Tobacco Cessation in Smart Quit Clinics; Multicenter.,Thailand

Amporn KROBTHONG, Thanut DOLAMPORNPHISUTH, Tippawan TEERASIRIROJ
Thai Health Professional Alliance Against Tobacco
The efficacy of foot reflexology in smoking cessation was evaluated by using a double-blind, randomized controlled trial. Sixty eight smokers enrolled in 4
Smart Quit clinics were recruited and allocated by using block-of-4 technique. The study was done during 1st June 2012 - 31 st December 2012. Study objectives
and research methods were explained to both experimental and control groups. Acupressure was performed by well-trained therapists at 20 specific acupoints
for the experimental group and other 20 specific acupoints for the control group. Each session takes approximately 20 minutes, and up to 15 sessions were done.
The urge to smoke and the patient’s feeling after treatments were assessed by questionnaire. Successfulness of the smoking cessation was assessed by using theFagerstrom test for Nicotine Dependence and piCO+Smokerlyzer.
In experimental group , taste change was reported in 73.53 % after the first foot reflexology session had finished and 79.41% at the end of the study. In control
group show 29.41 % taste change after the first foot reflexology session and 41.17% at the end . This result was statistically significant as analyzed by Pearson
Chi-Square Test (P<0.05). Furthermore, 61.8% of the patients in the experimental group and 11.8% of the patients in control group were successful in smoking
cessation (P<0.05). In addition, It was revealed that the efficacy of foot reflexology in smoking cessation was not associated with causes of addiction, initial
Fagerstrom Nicotine Dependence score nor duration of addiction.
In conclusion, foot reflexology could be a cost-effective and novel option for smoking cessation in Smart Quit clinics. However, a larger population andmodification of study design; for example, continuously monitor its effects and comparison of this technique with established therapies should be done in futurestudies.
Keywords : Foot Reflexology - Smoking cessation

P-S9-20

Web-Based Diet Management Program for Smoking Cessation: Content and Web Development

Faizah SAFINA, Zarina RAMLY
Universiti Malaya
Smoking cessation aims to encourage and help tobacco users to stop using tobacco and to avoid subsequent relapse. To achieve the aims, a range of techniques
including motivation, advice and guidance, counseling, telephone, internet support and appropriate pharmaceutical aids was offered in the smoking cessation.
However, post cessation weight gain may become the problem in achieving successful abstinence especially among weight-concerned smokers. Increase foodintake and decreased metabolism after quitting smoking explained this post-cessation weight gain.
The internet has the potential to deliver behavior change since usage of number of internet users increasing with time. To achieve success in smoking cessation
programs, interventions must be accessible, efficacious, cost-effective and transportable. Therefore, the internet is seen to be an effective way to deliver suchintervention not only for smoking cessation program but also applicable to the diet management program. This is because the internet based material is an
attractive intervention tool, low cost per user and can be accessed anywhere at any time. Besides that, it has the potential to reach audiences who might nototherwise seek support, because of limited health care provision or possible stigmatization.
Person who quit smoking often complain of weight gain after they quit smoking. Pharmacotherapies used in the smoking cessation such as nicotine replacement
therapy, verenicline and bupropion could delay the weight gain. However, their benefits in weight gain are limited because not all quitters will use the drugs
treatment during smoking cessation since it only applicable to quitters who previously smoke more than 10 cigarettes per day. Furthermore, once the drug
regimens are completed, the weight will be increases to what would have been reached if no medication had been used. Therefore, non-pharmacologicalintervention especially diet management should be applied to help with the weight gain problem. Diet management program through website provide many othercomponents such as meal planner, calculation of food calories and others which may not be covered by other delivery methods of diet management. Currently,
there is lack of dietary program which can be used in smoking cessation. Thus, this study is exploring the development of website on diet management forsmokers who quit on smoking.

P-S9-21

Cessation Support via Mobile Phone Text Messaging: Results from a Pilot Program in Suzhou, China

Pamela B. REDMON1, Erik M. AUGUSTSON2, Yixin DUAN1, Yaodong PAN3, Hanchang GAO3
Emory Global Health Institute1, National Cancer Institute2, Suzhou CDC Health Education Institute3
Cigarette smoking is ranked as the world’s leading cause of disease and death in the world, and China is home to over 300 million smokers. It’s estimated that
China’s death toll from tobacco-related diseases will exceed 2 million per year by 2020 if current smoking rates continue.
While the 2010 China GATS results showed that only 16% of current smokers are planning or thinking about quitting in the next 12 months, the recent media
attention to harms of tobacco use and secondhand smoke and broad increases in smoke-free policies will likely lead to increases in smokers’ desire to quit.
However, the logistics and potential costs of providing cessation services within China are daunting.
Mobile phone technology has shown positive results in helping smokers to quit in other countries. Given China’s wide-spread use of mobile phones, thetechnology has the potential to provide low-cost, in vivo support to smokers seeking cessation assistance. To assess usability and possible benefit, in summer2012 Suzhou offered a text-based cessation program to 665 smokers participating in their annual cessation competition. The messages were based on the
QuitNow TXT program developed by the US National Cancer Institute, and included motivational and behavioral change content. They were revised to reflect
cultural norms and translated into Chinese. Smokers enrolled in the text-based program received one text message per day, three days per week, for a total ofninety-two unique messages. At the end of the contest, 38% of the smokers who received the text messages reported complete abstinence. Quit success was
associated with lower indicators of nicotine dependence. High user satisfaction with the text program was reported.
Although preliminary, these results suggest that text-based cessation interventions hold substantial promise in China.

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Smoking Cessation Treatment Outcomes in Men and Women in Taiwan: Implications for Interpreting GenderDifferences in Smoking Cessation with Nicotine Patch

Kuang-Chieh HSUEH1,2,3,*, Shu-Chun HSUEH4, Ming-Yueh CHOU1, Ming-Shium TU1, McRobbie HYDEN3, West OLIVER3, Peter HAJEK3
Kaohsiung Veterans General, Hospital1, Shu-Zen College of Medicine and Management2, University of London Turner Street3, Meiho University4
Objective
Some clinical trials found lower smoking cessation rates in women than in men. It has been suggested that this may be due to self-selection rather than any
universal gender differences because population data and data from smoking cessation services in countries with similar smoking prevalence among genders
typically report only a marginal or no difference in quitting smoking in men and women. Data from smokers attempting to quit in countries with a large genderdifference in the prevalence of smoking could help to clarify this issue. We analysed data from a smoking cessation clinic in Taiwan, a country where 47% of
men but only 4% of women smoke.
Methods
The study sample included 1,179 smokers (1031 men and 148 women) seeking help at a Taiwanese smokers clinic between 2002 and 2009. Treatment included
nicotine transdermal patches and up to 8 support sessions. A range of baseline variables was collected together with self-reported smoking status at 3 and 6
months.
Results
Abstinence rates were significantly lower in women than in men at both 3 months (26.4% vs. 37.1%, p=0.011) and at 6 months (20.9% vs .33.8%, p=0,002). Men
and women differed in a number of baseline variables. In a multiple regression including all baseline variables, gender, age, cigarettes per day and whether thepatient tried to stop smoking previously were significant predictors of abstinence at 3 month, and gender, cigarettes per day, and stopping smoking previously
predicted abstinence at 6 months.
Conclusions
Among smokers seeking treatment in Taiwan, there is a significant gender difference in smoking cessation outcomes. The finding suggests that the lower successrates in women reported in this study could be revealed the result of gender differences to nicotine patch in smoking cessation clinic.

P-S9-23

Effects of Acupressure on Chinese Traditional Acupoints on Smoking Cessation

Thaniya KLINSOPHON, Premtip THAVEERATITHAM, Prawit JANWANTANAKUL
Chulalongkorn University
Objective: The aim of this study was to examine the effects of acupressure on smoking cessation by using magnetic beads at ear points
Design: Randomized Controlled Trials (RCTs)
Participants: 90 voluntary smokers (4 females), who were smoking addiction and expressed their desire to cease smoking, aged between 18 and 60 years old,participated in the study. Participants had good consciousness and did not have mental health problems.
Methods: Participants were randomized using computer program into 3 groups: control (who received only behavioral counseling), experimental (who received
auricular acupressure in Shen men and Lung points with behavioral counseling) and placebo groups (who received sham acupressure in Lie que; LU 7 point at
forearm and Tai chong; LV 3 point at dorsum of foot with behavioral counseling). Participants were asked to press magnetic beads when they felt the craving
and recorded their number of smoked cigarette in each day in a diary provided. Participants received treatment once a week for 4 consecutive weeks. Nicotine
dependence and nicotine withdrawal symptoms were collected every week. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were
measured at baseline and 4th week.
Results: The results showed that average number of smoked cigarettes per day in all three groups at the end of the study was significantly decreased compared
to before commencement of the study. No significant difference in number of smoked cigarettes per day among three groups. MIP and MEP in the experimentalgroup at the end of the study were significantly increased compared to before commencement of the study.
Conclusions: Auricular acupressure had no effect on smoking reduction but increased MIP and MEP after 4 weeks of auricular acupressure in Shen men andLung points. In addition, behavioral counseling may help smoking reduction.
Key words: Auricular acupressure, smoking reduction, acupressure

P-S9-24

Smoking Cessation Guide Books in Meiji Era Japan (1868-1912)

Hiroshi KAWANE, Sayuri WATANABE, Naoko TAKESHITA
Japanese Red Cross Hiroshima College of Nursing
The purpose of this study was to assess smoking cessation methods in the Meiji era in Japan. We investigated Japanese books published between 1868 and 1912
through the National Diet Library (Digital Library from the Meiji Era) to find descriptions of smoking cessation. There are 5 books which contained smoking
cessation in their titles and quit-smoking methods were shown in 3 out of 5 books. The titles of the books are “Kinshu kinen tebiki-so” (A guide to stopping
drinking and smoking), “Kinen no jikken” (Personal experience of quitting smoking) and “Jikken kinen-ho” (Experienced quit-smoking methods), respectively.
After examining these 3 books, the contents of each description were summarized. The first one, which was published in 1902, indicated the importanceof morals and willpower. The other two were both published in 1910 and described similar methods how to quit smoking. The necessity of motivation or a
motivational event was emphasized. The common smoking cessation methods are the “cold turkey” method (stopping completely all at once) and the gradualreduction method (cutting down gradually). Using a mouth wash of silver nitrate solution that changes the taste of tobacco was also recommended as a medicinal
treatment. One of the books mentioned that hypnosis is very beneficial to assist in quitting smoking. The use of a peppermint pipe was also suggested as a meansof decreasing cravings for smoking tobacco. It is interesting that smoking cessation guide books over 100 years ago had some descriptions of quit-smoking
methods which hold good even in our day.

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Socio-economic Status of Patients in Cessation Outpatient Department of General Hospitals

Kaoru INOUE1,2,3
Kyoto Tachibana University1, Kyoto Prefectural University of Medicine2, Kyoto Association for Tobacco Control3
Background
Although more than 100,000 people die because of smoking every year in Japan, cessation program in health insurance treatment had been started in 2006 andVarenicline had been introduced into Japan in 2008. On the other hand it is said that smoking is strongly related to socio economic status. However there was no
deep analysis concerning effects of the cessation program especially in general hospitals in Japan.
Objective
This research aims to make it clear the effect of cessation program in health insurance treatment and the background of smokers.
Methods
We did the follow-back study reviewing the charts of 348 patients in cessation outpatient department of 4 general hospitals through chi-square test and logistic
regression.
Results
79.3% of 241 men (56.7+/-14.1 years of age) and 62.6% of 107 women (48.8+/-13.7 years of age) patients have succeeded at the end of 3 months program.
Statistical significant differences in univariate analysis of men were seen in Supplemental Security Income, OR 0.29 [95%CI 0.11-0.78], suffering cardiovasculardisease, OR 0.47 [95%CI 0.23-0.93], suffering mental diseases, OR 0.40 [95%CI 0.18-0.89], CO of expired gas, OR 0.39 [95%CI 0.20-0.76], heavy smoker,
OR 0.48 [95%CI 0.23-0.99], living alone, OR 0.25 [95%CI 0.10-0.60], confidence for success, OR 2.73 [95%CI 1.20-6.23], Varenicline use, OR 2.28 [95%CI
1.16-4.49], having supporter, OR 1.96 [95%CI 1.30-3.72]. Those of women were only in Varenicline use, OR 3.53 [95%CI 1.40-8.91].
Multivariate analysis showed suffering mental diseases, CO of expired gas, Varenicline use, and having other smokers in house had statistical significant
differences.(OR= Odds Ratio, 95%CI= 95% confidence interval)
Discussion
Socio-economic statuses were related to success rate especially in men, while Varenicline use were effective to cessation.

P-S9-26

Smoking Cessation of Mentally-Disabled Persons: An Appication of Transtheoretical Model

KIe CHIDA , Yoshikatsu MOCHIZUKI 2Urakawa Public Health Center of Hokkaido Government1, Asahikawa Medical University2
1

PURPOSE: To elucidate the factors influencing on the stages of change on smoking cessation of mentally-disabled persons, according to the transtheoreticalmodel.
SUBJECTS: One hundred and eight persons using 4 psychiatric day-care facilities and 9 psychiatric workshop facilities in Hokkaido, Japan.
METHODS: An anonymous self-reported questionnaire survey was carried out from June to November, 2005. This questionnaire contained 4 constructs ofthe transtheoretical model; i.e., stages of change, processes of change, decisional balance, and self-efficacy. The odds ratios (OR) were estimated by logistic
regression analysis when compared contemplation (C) group with precontemplation (PC) group as 1, or when compared preparation (P) group with C group as 1.
RESULTS: Among 10 items of processes of change, 2 items of experiential processes showed OR=2.15 (Easy method for quitting), and OR=1.74 (Voice of
patients suffering from throat cancer or lung cancer) by comparing C vs PC. Only 1 item (I reward myself when I don’t smoke) of behavioral process showed
OR=2.05 by comparing P vs C. Among 6 items of decisional balance, 1 item (Smoking helps me concentrate and do better work) of Pros showed OR=0.65
by comparing C vs PC. One item (I’m embarrassed that I have to smoke) of Cons showed OR=1.72 by comparing P vs C. On the other hand, 1 item (People
think I’m foolish for ignoring warnings about cigarette smoking) of Cons showed OR=1.67 by comparing C vs PC, and OR=0.57 by comparing P vs C. Among
6 items of confidence, 3 items showed OR=2.58 (With friends at a party), OR=0.50 (Over coffee while talking and relaxing), and OR=4.25 (When I realize
I haven’t smoked for a while) by comparing C vs PC. However, no significant OR was shown by comparing P vs C. Among 9 items of temptation, 4 items
showed OR=2.47 (When things are not going may way and I am frustrated), OR=0.35 (When I am very angry about something), OR=0.52 (When I realize I
haven’t smoked for a while), and OR=0.53 (When I feel I need a lift) by comparing C vs PC. Two items showed OR=2.10 (With my spouse or close friend who
is smoking), and OR=0.56 (With friends at a party) by comparing P vs C.
CONCLUSION: This study suggested that different influences of the factors belonging to the constructs of transtheoretical model at each stage of change on
smoking cessation of mentally-disable persons.

P-S9-27

The Effectiveness of Outpatient and Inpatient Smoking Cessation Programmes at Khoo Teck Puat Hospital: Is ThereAny Difference?

Pei C. YONG, Su F. OH
Khoo Teck Puat Hospital
A total of 52 outpatients were counselled in the clinic setting from October 2010 to September 2012 whereas the inpatient program started on February 2011 and a total of 444 patients were counselled during the 20months period. In this prospective analysis, we investigate the differences in quit rates between these two programs.
Socio-demographic data, existing co-morbidities, stages of change (as defined by the Transtheoretical Model) and the number of sticks smoked were documented at the first intensive counseling session with a
trained counselor. Each intensive counseling session lasted 30 to 45 minutes. Phone follow up was done at 3, 6, 9 and 12 months from the first encounter, to determine if the patient had quit or was still smoking.
Students' t-tests and one-way ANOVA were used to compare between subgroups for normally distributed continuous data and chi-square statistics for categorical data.
35 out of 52 outpatients who were seen between October 2010 to October 2011 were contacted. 224 out of 444 inpatients who were seen from February 2011 till October 2011 were contacted. Majority of patientswere male (94.3% and 92.0%) and Chinese (51.4%). More than half, 54.3% of outpatients were in the action stage whereas 53.1% of inpatients were observed to be in the contemplation stage. The quit rates at are
shown in the table below:
Outpatient Quit rates (%)
Inpatient Quit rates (%)
n = 52
N= 4443 months
17.3
7.4
6 months
13.5
7.2
9 months
15.4
6.8
12 months
19.2
6.8
Quit rate (point prevalence) = Number of patients who quit smoking at time contactedn
The quit rates observed in the outpatient group were higher than the inpatient group in general. However, such a direct comparison of quit rates between programmes may not give an accurate reflection to theeffectiveness of each programme due to the different sample sizes. Outpatients walk in for counseling whereas inpatients, who are already warded, are offered counseling before discharge. Hence, there is greater
accessibility to smoking cessation counseling for inpatients, resulting in a larger group of patients being counseled.
Although there is greater accessibility to counselling, majority of inpatient smokers were in the contemplation stage of change whereas majority of outpatient smokers were in the action stage. Hence, the readinessto change plays an important role in each smoker’s motivation to quit. This motivation would eventually translate to higher long term abstinence rates.

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Factors Affecting Motivation to Tobacco Cessation: Experiences from India

Rajmohan PANDA, Divya PERSAI
Public Health Foundation of India
Background:The reported willingness of tobacco users to quit tobacco use holds promise for tobacco cessation. We assessed the factors motivating quitting
tobacco use among tobacco users.
Methods: A cross-sectional study among 1559 tobacco users visiting selected public health facilities in 12 districts of Gujarat and Andhra Pradesh in theyear 2012. Respondents were selected by simple random sampling. Semi-structured questionnaire was used to capture socio-demographic and tobacco use
information and motivation to cessation (quit). Multivariable logistic regression analysis was used to obtain the Odds Ratios (ORs) of socio-demographic
variables as determinants for the outcome of motivation to quit tobacco use.
Results:Only one-third (26%) of the respondents plan to quit tobacco use in six months. Smokeless tobacco users (51%) were more motivated to quit tobacco
use as compared to smokers (37%). Less than half of the tobacco users (43%) belonging to low socio-economic status were motivated to quit tobacco use.
Respondents belonging to younger age group (less than 45 yrs) were 1.4 times more motivated to quit tobacco(51%) use as compared to those belonging to older
age-group (OR-1.4, CI-1.2-1.8, p value<0.05). Significant difference was noticed in motivation to quit in tobacco users between the state of Gujarat and Andhra
Pradesh.
Educated respondents (51%) were motivated to quit (33%) as compared illiterates (33%). We noticed significant difference in motivation to quit among educatedand illiterate respondents between the two states (p-0.01). Concern about the personal health (95%) was the major factor identified for motivation. About half oftobacco users mentioned society and family disapproval, price of tobacco products, smoking restriction, and advertisements on harmful effects as other factors
motivating quitting tobacco. Interestingly, tobacco users belonging to low socio-economic status regarded harmful health effects (84%) as the major motivating
factor in comparison to price of tobacco products (47%).
Conclusions:The study suggests that education, age, and socio-economic status play an important role in determining the motivation to quit tobacco use in
Indian context. Over half of the tobacco users were not intending to quit tobacco in the near future thus supporting the need for cessation strategies aimed atincreasing motivation among tobacco users. Future tobacco prevention efforts aimed at tobacco users with low socio-economic status should focus on benefitsof quitting and use economic cost figures to help them realize the economic burden of tobacco.

P-S9-29

The Importance of the Consultation Times to Make High Success Ratio of Smoking Cessation from the Analysis ofPatient’S Background, to Make Better Clinical Pathway

Akari OIKAWA, Misato TAKAHASHI, Mayumi TAKAHASHI, Haruna SAITOU, Rumi TAKAHASHI, Chikako HIBINO, Kayoko ABE, Misato OBARA,
Hiroshi TAMURA
Hiroshi Tamura's Hill-Top Clinic[PURPOSE]: To determine the difference of patient background between success group (the group that could keep smoking cessation more than 6 months) andfailure group (the group that could not keep smoking cessation 6 months) , who were treated smoking cessation clinic, to make better clinical pathway.
[SUBJECT] The patient who was treated in smoking cessation clinic since April, 2006 to March, 2012. In total 221 patients (160male and 61female).
[METHOD] We investigated of the tendency of the sex, score of Tobacco Dependence Screener (TDS), Brinkman index, underlying disease, difference of the
drug therapy and the number of consultation times between failure group and success group, and surveyed about our smoking cessation rate by telephone.
[RESULT] [Whole patient background] The number of male (n=160, age 52±14) was higher than the number of female (n=61, age46±12) (P < 0.01), but
their average age was not significant. TDS of the male (7.7±1.4) and that of female (7.8±1.4) is not significant, but Brinkman index of the male (762.8±400.5)
was higher than that of female (466.8±211.1) (P < 0.01). [Telephone survey]According to the result of the telephone survey about smoking cessation rate, thepercentage of replies was 68% (150 patients). Six months smoking cessation rate was 68% (102/150), one year smoking cessation rate was 54% (81/150). There
was no significant difference between success group and failure group from the point of their age, TDS, Brinkman index, underlying disease, difference of thesmoking cessation drug. But the number of consultation times was higher in the success group (3.8±1.2) than that of the failure group (2.7±1.6) (p<0.01).
There was positive correlation between the success ratio and total number of visiting times to smoking cessation clinic. In only one visiting group the successratio was extremely low (19%). On the other hand, twice group 62%, thrice group 77%, four times group 76%, and full time (five times) group was 81%.
[CONCLUSION] The consultation time is a major factor related to the success ratio in smoking cessation clinic. So, medical staff must positively concern to thepatient, who is going to interrupt the smoking cessation clinic.

P-S9-30

The Influence of Strict Implementation of Safety Warning of Varenicline Concerning about Driving Motor Vehicle on a
Tobacco Cessation Clinic in Japan

Iwao GOHMA, Hiromi TAKAHATA, Yuko ASAI, Miyuki TSUTSUMI, Atsumi MATSUBAYASHI, Asuka KOKAWA
Tobacco Cessation Clinic at Sakai City Hospital
Purpose: We conducted prospective observational study to clarify the influence of strict implementation of safety warning of varenicline concerning about driving
motor vehicle on a tobacco cessation clinic in Japan. Japanese medical insurance system supports the smoking cessation program. In the program, nicotine patch(NP) or varenicline (VC) is available for cessation therapy. The ministry of health, labour and welfare in Japan stated that the warning which said the patientsshould not operate motor vehicle including driving personal car even for a short time while taking varenicline must be strictly implemented in October 2011.
Method: Retrospective observational study before the directive and prospective after that. Setting is a single tobacco cessation clinic in the tertiary hospital which
locates in urban area. Main outcome is the change of the rate of VC after the directive. Second outcome is the change of the abstinence rates of total patients and
NP or VC therapy each.
Results: We prescribed NP for 26 cases and VC for 63 from January, 2010 to September 2011. After the directive, NP for 43 and VC for 64 were prescribed during
12 months. The usage of VC was restricted from 70.8% to 59.8%, although the changes are statistically insignificant. The abstinence rates in the patients whocompleted the program are 53.8% in NP group and 61.9% in VC group before the directive, as compared with 55.8% and 68.8%, respectively after the directive.
Conclusion: As patients allowed attending the program only once during 12 months, we think the rather strict restriction leads to deprive the opportunity toreceive appropriate treatment from nicotine dependent patients.

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P-S9-31

Inpatient Smoking Cessation Program: Effect of Intensive Counseling Combined with Telephone Follow-up in South
Korea

Sun-Hee KIM, Jung-Ah LEE, Hong-Jun CHO
University Ulsan Medical College
Background
Cigarette smoking is a most preventable risk factor worldwide and in South Korea. Hospitalization can be a good teachable opportunity for patient to quit
smoking. We introduced the smoking cessation program for hospitalized patient with intensive counseling and telephone follow-up after discharge and analyzed
the cessation rate and it’s predictors.
Methods
From September 2011 to October 2012 100 patients hospitalized in departments of neurology, cardiology, and pulmonology were consulted to smoking cessation
clinic at Asan Medical Center. Demographic characteristics of the patients were collected from the electronic medical records. Smoking related variables andnicotine dependency were evaluated with questionnaires. Intensive counseling of 30 minutes was provided by the third year family medicine resident. Telephone
follow-up was given by the nurses with the schedule of 1,2,4 weeks and 3 months after initial counseling. We reported the 3 month follow-up data after discharge.
Results
The 3 month-smoking cessation rate was 42% respectively. Demographic characters such as age, education, diagnosis of admission, duration of hospitalization,
numbers of counseling, out-patient visit, and smoking histories such as age of smoking initiation, duration of smoking, daily tobacco consumption (Fagerstromscore), previous quit attempt, pharmacotherapy were adjusted in multivariate analysis. There were no apparent predictors of successful smoking cessation.
However, duration of hospitalization (average 9.31 days in cessation success group and 6.69 days in cessation failure group) and total numbers of counseling(average 3.60 counsellings in cessation success group and 1.43 counsellings in cessation failure group) tended to have higher smoking cessation rate. As a result,
we might assume more severe disease or regular and continuous encouragement by counselor is related with successful cessation.
Conclusions
We achieved relatively higher (42%) 3 month-smoking cessation rate with good acceptability for the patients with small additional input.

P-S9-32

Motivational Interviewing to Enhance Nicotine Patch Treatment for Smoking Cessation among Homeless Smokers: A
Randomized Controlled Trial

Kolawole S. OKUYEMI, Kate GOLDADE, Janet L. THOMAS, Sara EISCHEN, Barrett SEWALI, Hongfei GUO, John E. CONNETT,
Jasjit S. AHLUWALIA, Ken RESNICOW, Lillian GELBERG
University of Minnesota Academic Health Center1, University of Michigan School of Public Health2, University of California Los Angeles3
AIMS: To assess the effects of adding motivational interviewing (MI) counseling to nicotine patch for smoking cessation among homeless smokers
DESIGN: Two-group randomized controlled trial with 26-week follow-up
PARTICIPANTS AND SETTING: 430 homeless smokers from emergency shelters and transitional housing units in Minneapolis/St. Paul, Minnesota, USA.
INTERVENTION AND MEASUREMENTS: All participants received 8-week treatment of 21mg nicotine patch. In addition, participants in the intervention
group received six individual sessions of MI counseling which aimed to increase adherence to nicotine patch and to motivate cessation. Participants in theStandard Care control group received one session of brief advice to quit smoking. Primary outcome was seven-day abstinence from cigarette smoking at 26
weeks as validated by exhaled carbon monoxide and salivary cotinine.
FINDINGS: Using intention-to-treat analysis, verified seven-day abstinence rate at week 26 for the intervention group was non-significantly higher than for thecontrol group (9.3% vs. 5.6%, p=0.15). Among participants that did not quit smoking, reduction in number of cigarettes from baseline to week 26 was equallyhigh in both study groups (-13.7 ±11.9 for MI vs. -13.5 ±16.2 for Standard Care).
CONCLUSIONS: Adding motivational interviewing counseling to nicotine patch did not significantly increase smoking rate at 26-week follow-up for homelesssmokers.

P-S9-33

Smoking Cessation with Psychiatric Outpatients at a Private Psychiatric Hospital in Japan

Masami SATO
Tokyo Musashino Hospital
INTRODUCTION: Comorbidity of mental illness is a risk factor that makes it difficult to quit smoking compared with the general population, and more likely
to interrupt treatment. For about 70% of patients attending our smoking cessation clinic have mental illness, we began to make a phone call when the patientdoes not visit, and after 6 and 12 months from the first clinic visit to prevent treatment interruption since January 2010. We evaluated the safety and efficacy ofstandardized smoking cessation program in outpatients with mental illness.
METHODS: The sample consisted of 425 patients who attended the smoking cessation program at a private psychiatric hospital in Japan between February 2007
and December 2012. All patients were scored ≥200 on Brinkmann index and ≥5 on Tobacco Dependence Screener. Patients were seen by a physician and nurses
for up to 5 sessions in 12 weeks. Medication use was guided by patient preference (271 opted for varenicline and 149 for the nicotine patch, 5 without drugs).
Abstinence was defined as no smoking more than 4 weeks on the day of the final session, verified by carbon monoxide level. Patients with mental illness wareobtained with the permission of the family psychiatrist to receive treatment for quit smoking in advance.
RESULTS: Gender of the subjects was 61.4% male. Their mean age was 46.3 years. 76.2% of them had received psychiatric treatment during the period ofsmoking cessation program.
The overall rate of completion of treatment was 51.5%, there was no statistically significant difference according to whether or not receiving psychiatrictreatment.
It was 74% patients had been able to maintain abstinence for 4 weeks at the time of 5th examination, but who were receiving psychiatric treatment had asignificantly lower abstinence rate(70.7%).
Varenicline users had a significantly higher abstinence rate than those using nicotine patch at 12 weeks (80.1% vs. 66.7%). But varenicline users had more
incidences of adverse events, and 3.5% of them changed to nicotine patch. Abstinence rates of mental illness patients were 75.8% varenicline-treated and 61.5%
nicotine patch-treated, 100% without drugs.
CONCLUSION: There is a certain effect in standardized smoking cessation program for outpatients with mental illness.

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P-S9-34

Predictors for Successful Smoking Cessation and Its MaintenanceAyako OKUNO1, Midori YAMANA1, Naohiko FUJII1, Hiroyuki NARAHARA1, Yoshihiro CHIMORI2
Hyogo Prefectural Nishinomiya Hospital1, Kawanishi City Hospital2
Background and Aim:
Ultimate goal for smoking cessation is lifetime maintenance of smoking abstinence. In a Japanese clinical trial, 65.4% of the subjects taking varenicline achieved
smoking cessation at week 12, while it fell down to 34.6% at week 52. It is thus important to develop some tools to prevent smoking relapse and to sustain asmoke-free lifestyle for a long time. The aim of this study is to clarify the factors that affect the probability of successful smoking cessation and its maintenance.
Method:We conducted a single-centered retrospective cohort study in the smoking cessation unit of Hyogo Prefectural Nishinomiya Hospital. The subjects wereconsecutive outpatients who started the standard cessation program (five visits during three months) from April 2008 to October 2012. The information aboutsmoking status was collected at the end of the program and at the end of 2012 by telephone inquiry. Multivariate logistic regression analyses using stepwise
method were performed to examine the factors that affect sustained smoking cessation at the two different time points, respectively.
Result:In total, 143 subjects (96 males, 56.9 years old on the average) were included in the analyses. Either varenicline or nicotine patch was prescribed to the study
participants (103 and 39, respectively). At the end of the program, 69% (98/142) of the subjects achieved smoking cessation. Only 69% (53/89) of those who had
succeeded sustained a smoke-free lifestyle at the end of 2012. Multivariate logistic regression analysis with stepwise method for successful cessation at the end of
the program by using age, sex, Brinkman Index (BI), Tobacco Dependence Screener (TDS), blood CO level, and self-confidence score at baseline as independent
variables revealed that older age (P=0.007) and lower BI (P=0.03) were significantly associated with better outcome. However, for successful maintenance ofsmoke-free lifestyle at the end of 2012, we did not find any statistically significant association between these covariates.
Conclusion:Older age and lighter history of smoking were independently associated with higher probability of successful smoking cessation through the cessation programin a short run. Yet, a key to successful maintenance of smoking abstinence in a long run is unclear. Further research is needed.

P-S9-35

Evaluation of Social Nicotine Dependence Using the Kano Test for Social Nicotine Dependence (KTSND-K)
Questionnaire in Patients with Lung Cancer

ChulHo OAK1, TaeWon JANG1, MaanHong JUNG1, EunKee PARK1, Chiharu YOSHII2
Kosin University College of Medicine1, Wakamatsu Hospital of University of Occupational and Environmental Health2
Background: Smoking is one of the most important leading causes of lung cancer. Smoking is recognized as nicotine dependence, which consists of physicaland psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed aquestionnaire. However, there was no data obtained relating to lung cancer cases from the questionnaire given. We examined the social nicotine dependence
among lung cancer patients.
Method: We applied Korean version of KTSND questionnaire (KTSND-K) to 120 patients with lung cancer, and analyzed a complete data from all of them.
Among 120 patients, 100 data were obtained from patients just after their initial diagnosis of lung cancer, and 20 data were from patients before their diagnosisof lung cancer and after their first cancer treatment, respectively.
Result: The mean age of the respondents was 65.8±11.6. Among them, males were 67.8%. Current smokers, ex-smokers, and never-smokers were 24%, 47%,
and 29% respectively. The average KTSND-K score of 100 patients after their initial diagnosis of lung cancer was 12.2±4.7. According to smoking status, thetotal KTSND-K scores of current smokers were significantly higher than those of ex-smokers, and of never-smokers (13.8±5.4 versus 12.0±5.5, and 10.5±5.5,
p<0.001). The total KTSND-K scores of males were higher than those of females, suggesting that males have a propensity for being socially nicotine dependentmuch more than females (12.7±5.7 and 11.0±5.4, respectively, p<0.05). According to the status of the diagnosis and treatment, the total KTSND-K scores of 20
patients before diagnosis were significantly higher than those after their initial treatment (18.7±4.7 and 7.9±4.4, respectively, p<0.001). The mean changes of
KTSND-K scores of current smokers and ex-smokers after their cancer treatment were significantly larger than those of never-smokers (12.5±3.4 and 13.0 ±4.5,
versus 6.5±3.5, p<0.001).
Conclusion: Our study suggested that the KTSND-K questionnaire could be a useful method to evaluate psychosocial aspects of smoking to patients with lungcancer and that it would be useful for lung cancer prevention program.

P-S9-36

Psychometric Testing of the Chinese Version of the Cigarette Withdrawal Scale in Taiwanese Male Smokers

Chih-Ling HUANG1, Hui-Wen HUANG2, Kuang-Chieh HSUEH3
Chang Jung Christian University1, Chi Mei Medical Center2, Kaohsiung Veterans General Hospital3
Purpose: This paper reports a study estimating the psychometric properties of the Chinese version of the Cigarette Withdrawal Scale (CWS).
Design: Two phases were conducted between June 2007 and June 2009. First, the underlying factor structure using exploratory factor analysis (EFA), criterion
validity, and reliability of the Chinese version of the CWS were tested. Reliability was conducted to assessment the internal consistency and stability of the
instrument. The alpha coefficients for the scale and subscales were computed. Stability was evaluated with 2-week test-retest coefficients using an averagemeasure intra-class correlations coefficient (ICC). Second, the factor model proposed by previous empirical research was validated using confirmatory factor
analysis (CFA). A total sample size included in final analyses was 497. Participants were volunteers recruited from community in southern Taiwan. The inclusion
criteria for participants were being a male over the age of 18 years, currently smoking at least weekly or daily in the past year, and having smoked 100 or morecigarettes in their lifetime and had deprived of nicotine experience.
Results: the CWS was found to be internally consistent. The results of EFA showed that there are six factors, including Depression-anxiety (4 items), craving (4items), irritability–impatience (4 items), difficulty concentrating (3 items), appetite–weight gain (3 items), and insomnia (3 items). Six factors that account for
80.3% of the variance emerged from the exploratory factor analysis. Most item subscale and the full scale are significantly associated with the FTND (r =.25–.50,
p < .05), except the subscale of appetite–weight gain (r =0.12, p = .09). Cronbach’s alpha of six subscales and the full scale were respectively calculated at 0.92,
0.87, 0.87, 0.89, 0.91, 0.86, and .93, with retest coefficients of 0.74, 0.64, 0.77, 0.73, 0.68, 0.21, and .84. The results of the CFA analyses indicated that the CWS
was a six-correlated factor based on the fit index (NFI .97, NNFI .98, CFI=.98, RMSEA .07, and SRMR .04). All of these indices demonstrated that the proposedmodel was a good fit for the data.
Conclusion: Field testing revealed the CWS to be a reliable and valid Chinese-language instrument to assess cigarette withdrawal symptoms. The results help
health professionals to focus on smoking cessation interventions tailored to the patterns and severity of withdrawal symptoms.
Keywords: cigarette withdrawal, validity, reliability

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P-S9-37

Lessons Learned about Smoking and Relapse Following the Christchurch Earthquakes

Vivien A. DALEY
Cantabury District Health Board
The magnitude 7.1 Canterbury earthquake in September 2010 and associated aftershocks caused untold damage, drastically changed residents' living, working,social conditions and took the lives of 185 people. A local study (currently seeking publication) has shown that the prevalence of smoking increased following
both the September 2010 and the February 22 2011 quakes, mainly attributable to ex-smokers relapsing. Tobacco consumption in those currently smoking
increased. This presentation outlines the need for disaster planning to include initiatives to ensure access to Nicotine Replacement Therapy (NRT) to people
making quit attempts following a disaster and to ensure that relevant public health messages around smoking are promoted and distributed.

P-S9-38

Psychological Characteristics in Patients during Treatment of Tobacco Dependence

Akiko MATSUDA1, Junichi HASEGAWA2, Xinhui WANG2, Satoshi TSUNO2, Norimasa MIURA2
Tottori University【purpose】We investigated the present status of tabacco dependence and the mood states in patients during treatment of tobacco dependence for the purposeof psychological support.
【method】Healthy volunteers ‘aged 25-70 were enrolled in this study. Inpatients and patients with cancer and allergy were excluded. The mood states, thetobacco dependence score (TDS), urinaly cotinine concentration, expiratory CO concentration, brinckman index were compared between smoking cessation
patients(N=7) and smokers(N=18). The abbreviate profile of mood states (A-POMS) used in this study is a revision of an earlier version of the profile of moodstates. It contains 30 items rated on a 5-point scale from 0(not at all) to 4(extremely). Subscale include 5 negative mood factor (tension-anxity, depressiondejrction, anger-hostility, fatigue and confusion-bewilderment) and positive mood factors (vigor-activity). The mood state was assessed before and after thetreatment in both groups. The study protocol was approved by the institutional review board in University faculty of medicine.
The patient received standard program of treatment of tobacco for 12 weeks, while the smokers were just observed with no treatment.
【Result】The average age was significantly higher in smoking cessation patients than that in smokers.
Cessation medications are oral valenicline (N=6) and batch of nicotine (N=1).
There were no significant differences A-POMS points and TDS points in the both groups at the base line.
Smoking cessation patients felt much more difficulty in quitting of smoking and stronger withdrawal symptoms than those in smokers.
Brinckman index and expiratory CO concentration were significantly higher in smoking cessation patients than those in smokers. The depression- dejection statein smoking cessation patients tended to reduce at the end of observation and it was improved.
【Conclusions】 Counseling in treatment of tobacco dependence may be effective procedure in prevention of depression-dejection during smoking cessation.

P-S9-39

Patterns of Posting Behaviour in an Online Cessation Community

Benjamin HEALEY, Janet HOEK
University of Otago
Background: Recent evidence suggests that smokers who have social support when they make a quit attempt are more likely to become and remain smokefree.
Some smokers access this support from their families and friends, while others find it in online cessation communities, which have evolved rapidly in recent
years. Although the use of these communities is typically organic, analysis of community members’ posting behaviours may suggest interventions that could
further increase engagement and thereby improve the chance quitters will successfully become or remain smokefree.
Objectives: To analyse patterns in the posting behaviour of quitters using the New Zealand Quit blog site and identify potential interventions that could reduce
relapse.
Methods: We extracted over 125,000 blog posts and comments from the Quitline online community from January 2010 through to October 2012. Data captured
included anonymous user identifiers, post (or comment) date, and the links between posts and comments. This enabled a range of site usage and behaviouralanalyses to be performed, including activity by day-of-week, user posting frequency, individual posting initiation and fall-off, and between-user interaction
mapping.
Results: Day-of-week analyses show postings peak from Monday to Thursday, but decline sharply from Friday to Sunday. Smokers may start the week intending
to quit and cease posting towards the end of the week, when increased social interactions lead them to relapse. Analysis of individual bloggers’ behaviour
supports this interpretation; of those who first posted in Q1 2011 or 2012, most (60%) made posts on only one or two days; only 10% posted on more than 20
days. However, those who post on five or more days during their first week of joining the community are considerably more likely to continue posting and, by
implication, to have stayed smokefree. Posting frequency and interaction analyses also show that a small number of highly active ‘super users’ drive a substantial
amount of the support interaction in the community.
Conclusions: These analyses suggest opportunities to target both support and reactivation direct messages. Supporting quitters by posting smokefree tips near
the end of the week may reduce relapse; re-engaging quitters who post infrequently during their first week may promote greater engagement and more successful
quit attempts, and re-activating members who cease posting may stimulate more frequent and, ultimately, more successful quit attempts. There may also be
opportunities to better direct the support activities of ‘power users’ toward these aims.

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P-S9-40

Socio-economic Status of Patients in Cessation Outpatient Department of General Hospitals

Kaoru INOUE
Kyoto Tachibana University
Background
Although more than 100,000 people die because of smoking every year in Japan, cessation program in health insurance treatment had been started in 2006 andVarenicline had been introduced into Japan in 2008. On the other hand it is said that smoking is strongly related to socio economic status. However there was no
deep analysis concerning effects of the cessation program especially in general hospitals in Japan.
Objective
This research aims to make it clear the effect of cessation program in health insurance treatment and the background of smokers.
Methods
We did the follow-back study reviewing the charts of 348 patients in cessation outpatient department of 4 general hospitals through chi-square test and logistic
regression.
Results
79.3% of 241 men (56.7+/-14.1 years of age) and 62.6% of 107 women (48.8+/-13.7 years of age) patients have succeeded at the end of 3 months program.
Statistical significances in univariate analysis of men were seen in Supplemental Security Income, OR 0.29 [95%CI 0.11-0.78], suffering cardiovascular disease,
OR 0.47 [95%CI 0.23-0.93], suffering mental diseases, OR 0.40 [95%CI 0.18-0.89], CO of expired gas, OR 0.39 [95%CI 0.20-0.76], heavy smoker, OR 0.48
[95%CI 0.23-0.99], living alone, OR 0.25 [95%CI 0.10-0.60], confidence for success, OR 2.73 [95%CI 1.20-6.23], Varenicline use, OR 2.28 [95%CI 1.164.49], having supporter, OR 1.96 [95%CI 1.30-3.72]. Those of women were only in Varenicline use, OR 3.53 [95%CI 1.40-8.91]. Multivariate analysis showedsuffering mental diseases, CO of expired gas, Varenicline use, and having other smokers in house had statistical significances.
(OR= Odds Ratio, 95%CI= 95% confidence interval)
Discussion
Socio-economic statuses were related to success rate especially in men, while Varenicline use were effective to cessation

P-S9-41

Paradise Lost: A Hypothetical Theory of Nicotine Dependence

Takeshi ISOMURA
Reset Behavior Research GroupIn addiction, the neural reward circuit and cognitive distortion play an important role; however, their relationship has not been addressed yet. We reviewed recent
findings about nicotine dependence and propose a novel hypothesis in this article. Previous research using fMRI shows that while the activation of the reward
circuit (ventral striatum) to tobacco-related reward appears in nicotine dependence, responses to rewards other than tobacco (ex. food and money) are reduced.
Moreover, this change is observed at the very early stage of smoking, such as cases when the lifetime smoking experience is less than ten years. We thus propose
the following hypothesis, called the Paradise Lost theory. Given addicts’ lower response of ventral striatum to non-tobacco rewards, the addiction disables
smokers from sensing the pleasures of ordinary life (the Paradise Lost state). However, since smokers do not notice this, they produce the overestimation totobacco (cognitive distortion) such that they do not engage in any other pastime other than smoking, or that quitting smoking brings distress and unhappiness. The
cognitive distortion makes it difficult for smokers to start to quit smoking, and even causes relapses after quitting smoking. This theory furthers our understandingof addiction and improves our approach to the prevention and treatment of addiction.

P-S10-01

Is Urinary Cotinine Level of Children Useful to Predict Whether Their Parents will Quit Smoking in Future?

Kazuo KUROSAWA1, Toshihiro INO1,2
Ino Clinic1, Gunma Paz College2
Background: Since 2007, we have started the passive smoking screening program and previously reported the definite efficacy of this screening. One of these
efficacies was that measurement of cotinine concentration in children might motivate their parents to quit smoking. The purpose of this study was to evaluate
whether quit smoking of parents can be predicted by the level of cotinine in their children.
Methods: One thousand four hundred and one elementary school children were enrolled into this study. The age was ranged from 9 to 10 years-old with maleto female ratio of 1.2/1.0. In all children, urinary cotinine concentration was measured by using enzyme-linked immunosorbent assay and questionnaire survey
regarding smoking status of parents was performed. After 5 years follow-up, same questionnaire survey regarding smoking status of their parents was reevaluated. Statistical analysis was used by ANOVA and X2 test and p value <0.05 was defined as significant.
Results: The initial smoking prevalence of father and mother was 54% and 20%: both parents smoked in 15%, only mother in 5%, only father in 39% and bothparents don’t smoke in 41%, respectively. After 5 years follow-up, 61.1% of fathers who had smoked remained to be smoking, 14.5% smoked in moderation,
4.1% of those quitted smoking temporarily, 17.5% quitted smoking. Similarly, 45.3% of mothers who had smoked remained to be smoking, 29.5% smoked inmoderation, 4.5% of those quitted smoking temporarily, 16.9% quitted smoking. Ninety percent of fathers and 91.9% of mothers who quitted smoking had not
any therapeutic support and only 5-6% of those had visited to outpatient clinic of smoking cessation or received nicotine replacement therapy. In relationshipbetween urinary cotinine level of children and parental smoking status, mean level of urinary cotinine was elevated in children whose parents remained smoke(mother:10.8ng/ml, father:5.1ng/ml) > smoke in moderation (mother:9.8 ng/ml, father:5.6 ng/ml) > quitted smoking temporarily (mother:4.3 ng/ml, father:2.0
ng/ml) > quitted smoking (mother:2.6 ng/ml, father:2.2 ng/ml) in order, which were statistically significant (p<0.001). These results revealed that prevalence ofquit smoking during 5 years was significantly low in parents whose children had high level of urinary cotinine concentration.
Conclusion: It is possible that parents whose children had low level of cotinine concentration may consider negative effects of second hand smoke to theirchildren and had already had a motivation for quit smoking from the first. In addition, the relationship between CYP2A6 gene and parental smoking cessation
should be discussed.

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Background

P-S10-02

Looking after the wellbeing of the employees is an essential and indispensable part of any

An Analysis on the Smoking Related Psychological Factors
and Socioeconomic
in 1006
Smokersorganization.
An organization isStatus
responsible
for thedevelopment of the community at large andthe environment surrounding it.

Xiao-nong ZOU1, Zhen DAI2, Yuan-li CHEN2, Gong-bo CHEN2, HuanFeng FENG2, Ping ZHAO2
1 encouraging employees to focus
National Office for Cancer Prevention and Control, Cancer Institute/HospitalBy, Peking Union Medical College2 on key health behaviours such as increasing physical activity
improving eating habits, reducing stress, and ceasing tobacco and alcohol use.

Objective To study the smoking related psychological factors and the socioeconomic status among Chinese smokers. Methods A survey with Russell’s
Methods
Questionnaire on the Reasons of Smoking (RRSQ) was conducted anonymously
among 1 006 smokers and the data, including the histories of smoking,knowledge of tobacco control and psychological reasons of smoking was analyzed. Results High scores of the psychological reasons of smoking were foundConducted“Healthyand Happy
Living for5.15-5.52)
All” workshop
under CSR (5.15,
activity95%CI:
for GSECL -“Gujara
in the social needs (5.91, 95%CI: 5.73-6.09), sedation (5.76, 95%CI: 5.58-5.94), seeking
indulgence(5.33, 95%CI:
and stimulation
State Electricity Corporation Limited” covering Three Power Plants. Delivered 17 Sessions on
4.95-5.34). Male smokers had higher scores than female smokers on social needs(5.98 and 4.77. P<0.001) and seeking indulgence, (5.26 and 5.13, P<0.01).
Tobacco & Alcohol Awareness for the Employees, Family members, Students and Villagers.
Significant differences on social needs in smokers were found across the occupations, with higher scores in the category of medical science than the others(F=2.43, P=0.025). The scores of social needs and seeking indulgence of the married(6.14 and
5.38)
higherthan theChewing
unmarriedgroup (5.39
and 4.93)
Createdgroupawarenessabout
the wereharms
of Smoking,Tobaccoon Healthand environment.
significantly. Four social-psychological factors, including social needs, seeking indulgence, stimulation, and sedation were positively associated with the dailyof Tobacco
among target
groupsthrough Support andSolutions
to quitamount of smoking and negative associated with the knowledge of the healthDe-addiction
risks of smoking.
Conclusions
The majorsocial-psychologicalreasons
relatedto the habit.
smoking were the social needs, sedation, seeking indulgence and simulation in the smokers found in our study. Gender, occupation, marital status, history ofAwareness through Creative videos & posters along with effective presentation in regional
tobacco use and knowledge on tobacco control were important factors influencing
smoking.
language
has helped in achieving a better outcome.
Results

Out of 1800 employees who attended the sessions, we could see instant response from morethan 100 employees who have quit their addictions on the same day and many other havedecided to give away their addictions at the earliest.
In house medical staff has decided to support the addicts in quitting.

P-S10-03

CSR and HR teams have decided to conduct the Tobacco Free Workshops in regular intervals
for their employees.

“Towards a Tobacco-free Companies Healthy and Happy Living for All Workshops Through Corporate Social
Team Leads and Supervisors have decided to lead the movement in making Tobacco free Work
Responsibility”
Force in their departments.

Vijay B. YETAPU
VChangeU

Reported exposures to anti-smoking messages andtheir impact
on Chinese
smokers’havesubsequent
Family members
who attended
the workshop
decided toquit
keepattempts
their homes Tobacco Free forprotecting the other family members from Second Hand and Third Hand Smoking.

1
1
Ron Borlandpart, Hua-Hie, Geoffrey
Fong2,3, Yuan
Jiang4, Qiang
Li4,
LinandLi1*,indispensable
Background: Looking after the wellbeing of the employees is an essentialof any Yongorganization.
An T.
organizationis responsible
for the
5
2
,
Anne
C.K.
Quah
David
Hammond
The
Heads
of
the
Power
Plant
have
released
noticesandcirculars
toallemployees
development of the community at large and the environment surrounding it. By encouraging employees to focus on key health behaviours such as increasing and the Shop
Owners to ban the sale of Tobacco products and Prohibition of smoking in public places in their
physical activity, improving eating habits, reducing stress, and ceasing tobaccoand alcohol use. Methods: Conducted “Healthy and Happy Living for All”
1
power plants.
VicHealthCentre for Tobacco Control, Cancer Council Victoria, Australia
workshop under CSR activity for GSECL -“Gujarat State Electricity Corporation
Limited” covering Three Power Plants. Delivered 17 Sessions on Tobacco &2
Department of Psychology, University of Waterloo, Canada
Alcohol Awareness for the Employees, Family members, Students and Villagers.
Created awareness about the harms of Smoking, Chewing Tobacco on Health and3 Conclusion
Ontario Institute for Cancer Research, Canada
environment. De-addiction of Tobacco among target groups through Support
4 and Solutions to quit the habit. Awareness through Creative videos & posters along
Tobacco Control Office, Chinese Center for Disease Control and Prevention, China
with effective presentation in regional language has helped in achieving a 5better
Out of1800
employees
whoattendedtheWaterloo,
sessions,
we
could
Theoutcome.
great successof these
workshops
attributedtosign a yearlong
MOU withthe company andDepartmentof Results:
HealthStudiesand Gerontology,
UniversityofCanadasee instant response from more than 100 employees who have quit their addictions
on theupsame
andinmanyotherhaveother
decidedto give away
their addictions
has opened
newdaydoors
covering
many
companies
with similarworkshops for making
at the earliest. In house medical staff has decided to support the addicts inObjective:
quitting.
CSR
HRaimedteams
have
decidedto conduct
the Tobacco
FreetoWorkshops
their companies
TobaccoFree.
Thisandstudy
toexamineChinesesmokers’
exposureanti-smoking
in regular intervals for their employees. Team Leads and Supervisors havedecided in
toa range of channels and to determine if exposure was associated withmessageslead the movement in making Tobacco free Work Force in their departments.
Familysubsequent quit attempts. Methods: A prospective cohort design was employed.
members who attended the workshop have decided to keep their homes Participants
Tobacco Freewere 6,509 adult smokers who completed at least one of the first three
for protecting the other family members from Second Hand and Third Hand
Smoking.
waves(2006-2009) of the International Tobacco Control (ITC) China Survey,
The Heads of the Power Plant have released notices and circulars to all employees
and six Chinese cities. The main measures were reported exposure to
sampled fromthe Shop Owners to ban the sale of Tobacco products and Prohibition ofsmoking in messages in a range of channels and smokers’ subsequent quitanti-smoking
public places in their power plants. Conclusion: The great success of theseworkshops
attempts.
Generalized Estimating Equations (GEE) modelling was used to combine
attributed to sign a yearlong MOU with the company and has opened uprespondents
new doors infrom all three waves while accounting for inherent within-person
covering many other companies with similar workshops for making theircompaniesResults: The overall exposure levels to anti-smoking messages werecorrelation.
Tobacco Free.
low and varied between cities and from one channel to another. Television was themedium with the greatest overall exposure (over 50% in almost all the cities acrossall three waves). After controlling for a range of covariates, higher level of combined
P-S10-04 Reported Exposures to Anti-smoking Messages andTheir Impact
on Chinese
Subsequent
Quit
Attempts
exposure
were positively
relatedSmokers’
to higher subsequent
quit
attempts(adjusted odd
1
1
1
2,3
4
4 1.02~1.05, p<.001;2 also see Fig.1); among2
ratio=1.03,
95%
CI
the individual
Lin LI , Ron BORLAND , Hua-Hie YONG , Geoffrey T. FONG , Yuan JIANG , Qiang LI , David HAMMOND , Anne C. K. QUAH
channels exposures in newspapers and on posters were significant in their own right.
Cancer Council Victoria1, University of Waterloo2, Ontario Institute for Cancer Research3, Chinese Center for Disease Control and Prevention4
Conclusions: The findings suggest that anti-smoking warning messages have thepotential tomessages
stimulatemakequit attempts,
but they
indicate
Objective: This study aimed to examine Chinese smokers’ exposure to anti-smoking
in Chinese
a range ofsmokers
channelstoand
to determine
if exposure
wasalsoassociatedthe levels
and strength
warningmessages
in China
needsattoleast
be increased.
with subsequent quit attempts. Methods: A prospective cohort design wasthat
employed.
Participants
wereof6,509
adultsmokers whocompleted
one of theconsiderinternational
includingfirst three waves (2006-2009) of the International Tobacco Control (ITC)China
Chinashould
Survey,sampledadoptingfrom sixproven
Chinesecities. The practices,
main measures
weremandating
reported
pictorial healthwarnings
on cigarette
packages,
adopting(GEE)prominent
point-of-sale
exposure to anti-smoking messages in a range of channels and smokers’ subsequent
quit attempts.
Generalized
Estimating
Equationsmodelling
was usedwarnings,
and carryingout strong
and ongoing
mass
media campaigns.
to combine respondents from all three waves while accounting for inherent
within-person
correlation.
Results:
The overall
exposurelevels to anti-smoking
messages were low and varied between cities and from one channel to another. Television was the medium with the greatest overall exposure (over 50%
in almost all the cities across all three waves). After controlling for arange of covariates, higher level of combined exposure were positively
related to higher subsequent quit attempts (adjusted odd ratio=1.03,
95% CI 1.02~1.05, p<.001; also see Fig.1); among the individual
channels exposures in newspapers and on posters were significant intheir own right. Conclusions: The findings suggest that anti-smoking
warning messages have the potential to stimulate Chinese smokers tomake quit attempts, but they also indicate that the levels and strengthof warning messages in China needs to be increased. China should
consider adopting proven international practices, including mandating
pictorial health warnings on cigarette packages, adopting prominent
point-of-sale warnings, and carrying out strong and ongoing mass
media campaigns.

Fig.1 Relationship between combined level of exposure to anti-smoking messages and quit attempts

169P-S10-05

Teacher Tool Kit for Smoke Free School : Produce of Knowledge Management of Teachers Network, Thailand

Anong PUATRAKUL, Suwimon CHANPREMPRUNG, Thawatchai KOBOON
ThaiHealth Promotion Foundation
In 2005, ASH Thailand, began working with Smoke Free School network. The network has been consisted of teachers whose came from many high schools
with a common goal of enforcing smoke-free policy in secondary schools in Thailand. Its role and mission is in-line with the government policy intended
by the Notification 17, MOPH. Their work is to educate students about the harm of smoking and to instill the no-smoking value., At the moment, there areapproximately 2,000 teachers that are involved in the network
Objective
To develop and provide support the appropriate tool kit for teachers to implement smoke free school effectively.
MethodTeacher Tool kit for Smoke free School has been developed by mobilizing participation among teachers of Teachers Network and processed into 7 steps asthese follows. Step 1 is collecting the teachers need and desire and then made a precise of common goal is to produce an effective tool for building the learning
process for tobacco control in school Step 2 is reviewing and assessing the existing media of ASH regarding pros and cons by teacher representatives. Step 3 ismedia selection and discussion about how to adjust for more appropriated and then assigns subgroup to adjust and in order to keep up with the trend and social
development in the timely manner. Step 4 is sharing and learning from each other 14 stories; each story will contain 14 books as well as Power Point presentation.
Step 5 is distribution of the tool kit for trial in 6 pilot schools in the first round and 100 pilot schools in the second round. step 6 is monitoring and evaluation step
7 of reflecting the results of monitoring and evaluation.
Conclusion
Teacher Tool Kit is production of knowledge management and learning and developing process of ASH Thailand and Teachers network for providing more
effective tools for implementing and organizing smoke-free school. It is built through the lesson learned of teachers and schools so that it can truly benefit byincorporate this tool kit into their routine works such as in classroom, extra curriculum activities as well as the school activities.

P-S10-06

Beliefs about “High Grade” Cigarettes among Smokers in Seven Cities in China: Findings from the ITC China Survey

Qiang LI , Geoffrey T. FONG2,3, Anne C. K. QUAH2, Yuan JIANG1, Changbao WU2Chinese Center for Disease Control & Prevention1, University of Waterloo2, Ontario Institute for Cancer Research3
1,2

BACKGROUND: Cigarettes in China are divided into five grades, where higher grade cigarettes are more expensive. Chinese Tobacco Companies promote highgrades of cigarettes as “high quality” and “less harmful”. This study aims to examine Chinese smokers’ beliefs about high grade cigarettes.
METHODS: The International Tobacco Control Policy Evaluation (ITC) China Survey is a longitudinal survey of smokers and non-smokers in seven cities.
Data for this study come from Wave 3 of the ITC China Survey, which was conducted between May and October 2009. We computed the percentages of smokers
who believed that high-grade cigarettes are of higher quality and less harmful. Complex samples logistic regression was conducted to examine whether smokers
who hold the misperception that high-grade cigarettes are less harmful are also more likely to: 1) purchase more expensive cigarettes, and 2) believe that thecigarette brand they are smoking is less harmful.
RESULTS: The percentage of smokers who believed that high-grade cigarettes are of higher quality ranged from 59.9% in Yinchuan to 72.9% in Changsha; thepercentage of smokers who believed that high-grade cigarettes are less harmful ranged from 43.1% in Beijing to 63.5% in Kunming. Smokers who believed thathigh-grade cigarettes are less harmful were more likely to purchase the most expensive cigarettes (i.e., the highest price tertile) (OR=1.19, 95% C.I. 1.01-1.39).
Smokers who wrongly believed that high-grade = less harmful and who purchased cigarettes of the highest price tertile were also more likely to believe that thecigarette brand they are smoking was less harmful (OR=3.80, 95% C.I. 3.03-4.78).
CONCLUSIONS: More than half of Chinese smokers wrongly believed that high grade cigarettes were less harmful. Such misconceptions may drive smokers topurchase high-grade cigarettes, which may result in beliefs that the cigarette brand they are smoking was less harmful. Health education campaigns are urgently
needed to remove the misconception about high-grade cigarettes in China.
Key Words: high-grade cigarette, belief, China
Relevant Sessions: Education, communication, training and public awareness

P-S10-07

Self-Exempting Beliefs about Smoking in Predicting the Plan and the Success of Quitting in the Next Wave: Findings
from the ITC Korea Survey

Eon Sook LEE1, Jun Hyung LEE1, Hong Gwan SEO2, Yeol KIM2, Anne C. K. QUAH3, Geoffrey T. FONG3
Ilsan Paik Hospital1, National Cancer Center2, Department of Psychology, University of Waterloo3, Ontario Institute for Cancer Research4
Introduction: Self-exempting beliefs, which minimize or discount the harms of smoking, are also widely found among the smokers. Four types of beliefs havebeen identified in other studies, i.e. Bulletproof belief is the stereotype of self-exemption in that ‘the problem does not apply to me’; Skeptic belief discounts theharms of smoking, Jungle belief normalizes the dangers of smoking because of the ubiquity of risks, and Worth-it belief means the smoker believes it is worth
to continue to smoke despite its harm. Although these self-exempting beliefs could have association with the quit intention, the association has not clearly beenshown. This study is conducted to evaluate whether the self-exempting beliefs are associated with quit intentions and, in addition, whether these beliefs could
predict smoking cessation in Korea.
Methods: 1,659 adult (≥18 years) smokers from the Wave 2 data of International Tobacco Control (ITC) Korea Survey were employed for this analysis tomeasure self-exempting beliefs. Skeptic belief is measured by “Medical evidence that smoking is harmful is exaggerated”, Jungle belief by “Smoking is no
riskier than lots of other things that people do” and Worth-it belief by “You’ve got to die of something, so why not enjoy yourself and smoke” or “Smoking is
an important part of your life.” Only 3 out of 4 beliefs were measured for this study. Intention to quit measure is also included in the analysis. The successful
quit was assessed among 1026 respondents followed up in Wave 3. We evaluated the association between self-exempting beliefs and intention or successful quit
using multivariate logistic regression.
Results: The Worth-it belief among risk-minimizing belief was associated with quit intention after controlling covariate (O.R. 0.56, 95% CI 0.40-0.80, P 0.001).
This belief also had the capacity to predict the successful smoking cessation in the next wave (O.R. 0.54 95% CI 0.29-0.99, P 0.049). Other Worth-it belief(“Smoking is an important part of your life”) has shown to be associated with only quit intention (O.R. 0.60, 95% CI 0.43-0.84, P 0.003). The Skeptic and Jungle
beliefs did not show any association with intention or success to quit. Other factors influencing intention to quit were perceived by health concerns and concernof important person about their smoking.
Conclusions: Korean smokers with Worth-it beliefs showed less intention to quit and less success rate in quitting smoking. More creative approach should beconsidered to help the smokers with Worth-it belief to successfully quit smoking.

170

P-S10-08

Spread of Tobacco Free Campus in Japanese Universities

Masayuki TAKAHASHI, Takashi NISHIMOTO, Tomoya MURAKAMI
Biwako Seikei Sport College
BACKGROUND: Anti-smoking of educational facilities in Japan has spread since 2003 except for college or universities. Thus, we explored anti-smoking
policies and actions of 86 Universities in Japan, where students become legally smoking allowed age of 20 y.o.
METHODS: We sent questionnaire to 200 Universities and received results by facsimile in August-November 2012.
RESULTS: Tobacco free campus (TFC) means smoking is not allowed inside campus and tobacco is not sold. TFC were 33% of total universities, higher in small
size universities (43% vs 11% in large size campus), public universities (47% vs 25% in private universities), medicine and health related sciences (67% vs 14%
in sports and PE faculty, 0% in art faculty), and universities in Hyogo prefecture (69%. where local anti-tobacco law was enacted). Interestingly, 10% facilities
is planning TFC in near future, 7% in future, 8% no plan, and 43% considered tobacco free but have left smoking area. Most universities with TFC clearly
express no-smoking policies by poster, brochures, homepage etc. However, only 7% universities have punishment policies. Regular patrol of smoking students
by faculty staff is performed in 44% universities. Only 54 % universities have assigned a committee about anti-smoking problems. Lectures about tobacco orquit smoking is present only 7% of universities. Students can be treated for quit smoking in 20% inside campus and 15% have reference system for outside quit
smoking clinic. Although, TFC are increasing year by year., most universities replied some difficulty in controlling smoking students and faculty members after
establishment of no-smoking policy.
CONCLUSION: It is clear that passive smoking can be prevented only by TFC. Clarified problems were less tobacco related lectures, less publicity activities,
less punishment law (universities and/or local government), less specific committee, less quit smoking therapy. Stronger policies and actions will promote spreadof TFC in Japanese universities.

P-S10-09"Manga"-based Quitting Smoking Campaign in Health Insurance Society A

Tomomi NAGASHIMA1, Takeshi ISOMURA2
Nisseikyo Health Insurance Society, Research Group on Smoke-free Psychology1, Reset Behavior Research Group, Research Group on Smoke-free Psychology2【Background/Purpose】Many quitting smoking campaigns use webpages or brochures to appeal hazardous effects of smoking or methods to support quitting
smoking. These media, however, tend to only draw the notice of non-smokers or those who smoke but are highly interested in quitting smoking. It might cause
these campaigns hard to be spread far and wide. Therefore, we have been trying to promote quitting smoking campaign by using a more familiar information
tool, “Manga”.
【Methods】We created an original “Manga” by introducing some elements of Reset Smoking1), a psychological approach through triggering a chain reactionof awareness based on the Paradise Lost theory on addiction. Reset smoking is expected to have a positive effect not only to support smoking cessation but
also to prevent ex-smokers from re-smoking. The “Manga” was posted on the Society A’s webpages and also distributed at a health counseling desk or on otheroccasions in the form of a booklet.
【Result】The “Manga” was posted on the webpages in April 2010 and achieved about 9300 accesses for the first year. The number of the booklet distributed
for a year since August 2010 amounts to about 2000. Feedback from readers includes:
From smokers: “The “Manga” was so interesting that it made my view changed completely. I’ll try to start quitting smoking.” Some smoking readers indeed
quit smoking after reading the “Manga”.
From ex-smokers: “It seems to have changed my mind that I can keep on quitting smoking.”
From non-smokers: “My niece in elementary school read the “Manga” and was willing to introduce it to her father. “ “I realized that it was important to avoid
misunderstanding on smoking and encourage people to quit smoking.”【Conclusion】By using a “Manga” that illustrates friendly characters and familiar situations, the campaign was able to encourage a broad range including
people who were not interested in quitting smoking. This “Manga” worked out not only for smokers to motivate smoking cessation and for ex-smokers to preventfrom re-smoking , but also for non-smokers to understand the health risk caused by smoking and to promote quit smoking for others.
1) Isomura T. (2012) How to Reset Your Smoking. Kindle publishing

P-S10-10

Effectiveness of Clinical Pathway for Tobacco Cessation Program

Yoko KAIDO , Natsuko SATO1, Maki SUZUKI1, Sayori MIYANO1, Ekuko SENO1, Yumi ONO1, Satsuki YONEUCHIYAMA2, Etsuko TANAKA2,
Masayuki SAKURAI2, Ichiro SAKUMA1
Caress Sapporo Hokko Memorial Clinic1, Caress Sapporo Hokko Memorial Hospital2
1

Purpose: We have been practicing tobacco cessation education program since Aug 2004. Patients participating in the program have been increasing from 86
persons in 2009 to 138 patients in 2011. Because of the social background to facilitate tobacco cessation the number of patients is supposed to increase year
by year. Our education program is directed by a fellow doctor of the Japan Society for Tobacco Control and consists of a fellow nurse of the Japan Society for
Tobacco Control, two board certified member nurses of the Japan Society for Tobacco Control and two trained nurses for tobacco cessation program who are
actively performing patients’ education and two pharmacists who give suggestions to patients concerning drug usage and adverse reactions. In order to cope withan increase in participating patients who want to quit smoking, to standardize patients’ education and to perform program more smoothly we made a clinicalpathway for tobacco cessation program and started using it from July 2012. In the present study we tried to evaluate its clinical effectiveness.
Methods: Firstly, evaluation questionnaire sheets of clinical pathway were given to nurses and pharmacists who are engaged in the tobacco cessation education
program and their degree of agreement for the clinical pathway was assessed. Secondly, success rate of smoking cessation was compared and assessed between
before and after the start of the clinical pathway.
Results: All members of tobacco cessation program agreed that standardization of the program was achieved by applying the clinical pathway. Many members
felt that the clinical pathway made united patients’ education possible, efficacy of patients’ education was raised and mistakes during patients’ education weredecreased. Annual year success rate of smoking cessation increased from 69.5% to 84.2% before and after the start of application of the clinical pathway,
respectively.
Conclusion: To apply clinical pathway for tobacco cessation education program proved to be clinically effective by making performance of patients’ education
more smoothly with less mistakes.

171

P-S10-11

Association between Smoking Behavior, the Smoking Status of Their Parents and Friends and Own Self-denial Image
among University Students in Tokyo, Japan

Izumi SEZAI1, Tsunetsugu MUNAKATA2
Musashi University1, Institute of Health Behavioral Science2
Introduction: About 60% of high school students going on to college and junior college in Japan. Smoking behavior is typically established during university.
The purpose of this study was to obtain suggestion about the association between smoking behavior among university students and the smoking status of theirparents and friends as well as their own self-denial image .
Methods: Results from an anonymous, self-administered questionnaire survey in 1649 third-year university students ( 799 men, 850 women ) in areas aroundTokyo, in April 2006 and 2009 were statistically analyzed using logistic regression. We assessed smoking status of their parents and friends as well as thestudents’ own self-denial image. Independent variables were “never or ever smoker” and “not current or current smoker,” separated by sex.
Results: The prevalence of smoking was 32.0 % ( n = 256 ) in men and 6.7 % ( n = 57 ) in women. In men, the adjusted odds ratio (AOR) for “never- vs. exsmoker” was 3.43 ( 95% CI = 1.95 - 6.03 ) among individuals with any smoking friends, 2.57 ( 1.80 - 3.67 ) among individuals with 10 or more smoking friends,
and 1.40 (1.02-1.91) among individuals of high self-denial image. The AOR for “not current vs. current smoker” was 2.77 ( 1.39 - 5.54 ) among individuals withany smoking friends, with 10 or more smoking friends, and 2.68 ( 1.88 - 3.82 ) among individuals with 10 or more smoking friends. In women, AOR for “nevervs. ex-smoker” was 3.75 ( 2.23 - 6.32 ) among individuals with any smoking friends ,2.80 ( 1.71 - 4.58 ) among individuals with a smoking mother and 1.88 (1.16 - 3.06 ) among individual with 10 or more smoking friends. The AOR for “not current vs. current smoker” was 5.73 ( 1.98 - 16.63 ) among individuals withany smoking friends, and 2.90 ( 1.53 - 5.49 ) among individuals with 10 or more smoking friends.
Discussion and Conclusions: These findings suggest that smoking behavior of their friends influence smoking behavior among university students. In addition,
if their mother was smoker, female students were more likely to have experienced smoking. In men, a self-denial image influenced smoking behavior of them.
Therefore, when offering support to young smokers, it may be necessary to consider the psychosocial factors.

P-S10-12

Japanese Smoking Problems Which Became Clear from Interviews with Participants of the APACT 2010 Held in Sydney

Toshiharu ETO, Keiko AOISHI
Miyazaki University
Although the smoking rate in Japan has been falling thanks to measures against smoking and the ratification of the FCTC every year, it is still a high smoking rate
among advanced nations. The interview questionnaire about the smoking problem in Japan was performed among the participants of the APACT 2010. Twenty
one percent of the participants knew about the smoking rate in Japan. However, seventy eight point five percent of the participants answered that Japan had animage of a very high smoking rate. The participants mentioned the following five items as the reasons for the high smoking rate in Japan: 1) The government
produces tobacco. 2) The government does not provide people with the exact information about tobacco. 3) Tobacco is cheap. 4) Tobacco companies produce amisleading image of tobacco. 5) The government does not provide the youth with effective nonsmoking programs. Furthermore, it was proposed by a participantthat the smoking preventive program to the youth was important as effective solution which can lower the smoking rate in Japan.
Table: Free comments for the solution of the Japanese smoking problem
1. Although Japan has only one culture and is a Buddhist country, it has not controlled the tobacco problem.
2. Young smokers start smoking by imitating the surroundings. Social pressure is verified.
3. The smoking rate of Australia is 15%. We have many media campaigns against smoking.
4. Biggest Tobacco Company, low regulation tax rates, slim and pink color packages are the cause of high smoking rate of Japan.
5. Japan is an advanced industrialized country and shows a very high smoking rate. Government has to start programs for cessating smoking.
6. Although Japanese people are wise, the high smoking rate is a problem for the government policy.
7. Since the government sells tobacco, the smoking rate is high.
8. Perfect and exact information from the government, schools and homes need to be provided.
9. Tobacco industry is targeting the young generation.
10. A governmental smoking preventive program for young people is required.
11. When I went to Japan, many Japanese were smoking tobacco in public places.
12. The support system to prohibition of smoking of the government is indispensable.
13. Tobacco companies produce a misleading image of tobacco.

P-S10-13

What Messages Do Young Adult Smokers Believe will be Effective in Cessation Advertising?

Ninya MAUBACH, Janet HOEKASPIRE2025
Background: Despite New Zealand’s overall smoking prevalence of 17%, smoking rates peak at 30% among young adult women and men, and have notdeclined. Increasing cessation among young adults is going to be very important if NZ is to achieve the goal of smoking rates falling below 5% by 2025. Massmedia campaigns may prompt and support quit attempts, but young adults have found the predominantly health-themed messages less relevant and motivating
and research is urgently required to identify themes that would resonate more strongly with them.
Objectives: To understand the language used and concerns expressed by young adults to develop more effective quit messaging themes, and explore reactions
to these new themes.
Methods: Two phases of qualitative research were undertaken. In-depth interviews with 16 adults aged 18-31 years explored tobacco’s role in their lives, thebenefits and disadvantages of smoking and their views on existing cessation campaigns. The data were analysed thematically, and the results used by a to create
a set of 11 new cessation messages. Following a brief, a graphic designer created draft print advertisements that we tested in three focus groups with seven adults
aged 19-29 years. Those data were also analysed thematically.
Results: Young adults use smoking to structure their time and social interactions, and manage their moods. Most believed smoking was a temporary phase in
their lives, and that they would one day become smokefree. Metaphors of choice and control underpinned their confidence they would quit and was reflectedin their desire to decide when and how they would become smokefree. As a result, they responded well to messages that respected their desire to control their
quitting journey . Other themes also highlighted participants’ need to assert control and included concerns over smoking’s social unattractiveness, which they
could not control, effects on children, who did not choose exposure to tobacco, and industry manipulation, which undermined their independence and freedom.
Conclusions: Communicating young adults’ ability to assert control over smoking, the ease with which they can access support, and the benefit of regaining
control over their lives, appears likely to be more effective than didactic instructions to ‘quit now’.

172

P-S10-14

Tobacco Control-Why & How

Dilip K. ACHARYA
Cancer Society of Madhya Pradesh, GB Pant District Hospital, Indian Medical Association-Indore
Currently, there are an estimated 1.4 billion smokers in the world. If present consumption patterns continue, the number of deaths will increase to 10 million by
the year 2020, 70% of which will occur in developing countries, and India is of them. Objectives: In India, tobacco kills approx. 800,000 people every year.
India has the highest rate of oral cancer in the world due to Tobacco consumption. The objective is to make people fully aware of the Health Hazards of Tobaccoand to help them in quitting tobacco. Underlying values and principles: WHO has estimated that 91 per cent of oral cancers in South-East Asia are directly
attributable to the use of tobacco and this is the leading cause of oral cavity and lung cancer in India. Knowledge base/ Evidence base: Tobacco is the leading
cause of Oral, Lung and other cancers and also many other Cardiac, respiratory diseases. It has a very bad effect on women, pregnant ladies and children also. The
second hand smoke hazards are an established fact. In India, Tobacco is consumed in large quantity in different forms-cigarette,bidi,hookah and in SPIT tobacco(Pan, Gutka etc) form too. There are plenty of tools to help smokers quit their habit –websites, groups, email reminders, SMS support are being increasingly used.
Pharmacotherapy- like Nicotine Gums, Patches, nasal sprays and drugs like Bupropion & Varenicline are being increasingly used. But the cold turkey method has
still has the highest number of unaided quitters. Methods: The health hazards of Tobacco are to be discussed in detail in presentation. All Doctors & paramedical
staff & social workers should learn the “5A” of Smoking Cessation & tobacco control1. ASK every pt. about smoking.
2. ADVISE all patients & friends to quit tobacco
3. ASSESS their willingness to quit
4. ASSIST smokers with treatments and referrals &5. ARRANGE follow ups.
They should inculcate the habit of using the “5A” in their regular, day to day. Results and Conclusions: It is estimated that while roughly 70% of smokers saythey want to quit, 44% try to quit each year, most quit attempts are unaided & only 3-7% remain quit after one year. Increasing awareness about the health hazardsof Tobacco & aids for quitting will definitely decrease tobacco consumption and more and more smokers will quit in due course of time.

P-S10-15

How to Build and Operate a High Traffic Website -Using the JTF Official Website - E-Quit Chinese as an Example

Ching-Li LIN, Tzu-I LU, Jen-Huan HUJohn Tung Foundation
The “E-Quit Chinese”, which is a tobacco control advocacy website, was created by John Tung Foundation (hereinafter referred to as JTF). From the latter halfof 2007 to 2012, 26 million people had visited the website. It is one of the most well-known tobacco control websites in Chinese world. The following strategies
are used to maintain high web traffic:
1. Marketing Strategies:
The “E-Quit Chinese” constructed at the latter half of 2007 and revised in 2011. It contains both traditional Chinese and simplified Chinese versions in which
new information is updated frequently in order to and to attract more attention from the public.
JTF invites celebrities to support tobacco control, and sets up a column on the website for that purpose. With the celebrities' influence on the public, we could
draw more attention and reach our target group much easier; the “E-Quit Chinese” also cooperates with other blogs and websites, and creates fans page on
Facebook. Furthermore, through holding press conference and tobacco control activities, we could expand our target group and better realizing our goals.
2. Target Group:
The “E-Quit Chinese” offers information on how to cease smoking successfully, and for those who intend to help others to quit, the website also recommend
many effective ways in doing so.
The “E-Quit Chinese” offers the latest international news as well, including health warnings on cigarette packaging and tobacco control policies. Those
information may become a reference for some health promotion activities; as a result, has attracted health workers to frequently browsing the website.
With well-planned activities, sufficient useful information, and continuous expansion on the target groups, the web traffic of E-Quit Chinese has been largely
increased and information of tobacco control effectively distributed.

P-S10-16

What Effects of Smoking Ban in Indoor Public Places has on Smokers’ Perception, Their Attitude of Smoking aroundChildren and Implementation of Smoke-Free in Their Homes and Private Vehicles?: Findings from Intercept Study of
Smoke- Free Melaka City (SFMC) Policy

Noraryana HASSAN1 ,Maizurah OMAR2, Rahmat AWANG1,3, Yahya BABA3, Nur Hanani JASNI2, Ahmad Shalihin Mohd SAMIN2, Anne Chiew Kin QUAH3,
Pete DRIEZEN3, Mary THOMPSON3, Geoffrey T FONG3
Melaka State Health Departments1, Universiti Sains Malaysia2, Malaysian Health Promotion Board3, University of Waterloo4
BACKGROUND: Globally, exposure to secondhand smoke is responsible for 600,000 deaths in 2011. Unfortunately, 75% of these deaths were affecting womenand children. Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) specifically focused on protecting people
especially the non-smokers from exposure to tobacco smoke in all indoor workplaces and public places as well as all public transports. In Malaysia, Melaka has
implemented a 100% smoke-free city since 15th June 2011 with aims to protect the non-smokers especially women and children living with smokers.
OBJECTIVE: To examine the effects of Smoke-Free Melaka City (SFMC) Policy on perception, attitudes of smoking around children and implementationof smoke-free homes and private vehicles. METHODOLOGY: Data were collected in June 2012 using systematic intercept sampling. A total of 1039 adults
within smoke-free zones were recruited through a face- to-face interview of which 601 were smokers. Smokers’ perception and attitudes about the policy andawareness of smoke-free advertisements or information that talks about dangers of smoking and encouraged quitting were assessed. Descriptive analysis,
univariate and multiple logistic regressions were applied by using SPSS version 18. Odd ratio and 95% CI were computed for each corresponding variable.
RESULTS: Awareness of Smoke-Free Melaka City (SFMC) advertisements and information was significantly associated to perception that smoking ban was agood thing (OR= 1.21; 95% CI 1.11, 1.31, p<0.01). This perception was significantly associated with attitude would not smoke when children are present (OR=1.80; 95% CI 1.04, 3.11, p=0.035). This positive attitude was significantly associated with implementation of total smoke-free homes (OR= 3.64; 95% CI 2.17,
6.15, p<0.001) and private vehicles (OR= 1.81; 95% CI 1.11, 2.95, p=0.017). Awareness of SFMC advertisement and information was also directly associatedwith implementation of total smoke-free homes (OR= 1.09; 95% CI 1.01, 1.18, p<0.022) and private vehicles (OR= 1.19; 95% CI 1.09, 1.30, p<0.01).
CONCLUSION: Awareness of Smoke-free advertisements and information has both direct and causal effects on perception, attitude and implementation ofsmoke-free homes and private vehicles among smokers in Melaka. Thus, implementation of smoking ban in public places has potential to reduce exposure tosecondhand smoke among children in public places and who living with smokers.
Acknowledgment: The authors acknowledge the support and collaboration from the Universiti Sains Malaysia, Malaysian Health Promotion Board (MySihat),
Melaka State Department, and Coalition of Melaka Smoke Free NGOs (GANMBAR) and the University of Waterloo, Canada.

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Location of Smoking at Home, Asthma Control and Lung Function in School Children

Shuichi SUZUKI, Hiroko WATANABE, Yoko NEZU, Kazuki SATO, Toshiyuki NISHIMUTA
Department of Pediatrics, Shimoshizu National Hospital
Background:Tobacco cessation in family members is essential in management of pediatric asthma but is often difficult to achieve.It is unclear whether stopping
indoor smoking in family members can be recommended for patients with pediatric asthma.
Method: We evaluated school children with asthma who visited our hospital between December 2011 and January 2012 and collected data on presence ofsmokers in family members and location of smoking (indoor or only outdoor). Urinary cotinine was measured by ELISA. The primary outcome was acuteexacerbations during the last one year and lung function after inhalation of bronchodilator.
Results: A total of 93 patients were evaluated. The proportion of patients with a low urinary cotinine level (below 4 ng /mg creatinine: 20th percentile inparticipants) was 100% in patients without smoking family members (n = 35), 90% in patients with outdoor-smoking family members (n =22), and 44% in
patients with indoor-smoking family members (n = 36). The rates in regular use of inhaled corticosteroids and leukotriene receptor antagonists were similar
among three groups. The proportion of patients who had no acute exacerbation during the last year were 82%, 85%, and 58%, and the average peak expiratory
flow rate after inhalation of bronchodilator were 102%, 100%, and 92%, respectively. Only the values in patients with indoor-smoking family members weresignificantly lower than other groups of patients. Similar results were found on maximal midexpiratory flow and flow at 50% remaining vital capacity after
inhalation of bronchodilator.
Conclusions: Outdoor smoking in family members, unlike indoor smoking, seems not to be associated with poor asthma control and decreased lung function inschool children with asthma. Our results may substantiate the recommendation that smoking family members of patients with pediatric asthma should smoke
outdoor for better outcomes.

P-S10-18

A Study on Effectiveness of School Tobacco Control Program in Myanmar

Aung TUN, Su M. MYAT, Phyu T. HAN, Thuya AUNG
Ministry of HealthObjective: The study aims to reassess the health, knowledge and practice of students, (5th,6th and 7th Graders )after the introduction of School Tobacco Control
program. This study includes data on prevalence of cigarette, cheroots, other tobacco and betel quid with tobacco use as well as information on five determinantsof tobacco use: access, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum.
Methods: A school-based survey (n=2669, 5th,6th and 7th Graders) was conducted in (4) basic education middle and high schools of Nay Pyi Taw, Myanmar in2011, using a pre-tested modified questionnaires based on the Global Youth Tobacco Survey questionnaires developed by CDC, USA. The class response rate
was 100.0% and the student response rate was 95.02% and overall response rate was 95.02%. A total of 2669 students participated in this study.
Results: About 5.5% of students were currently smoking at the time of survey, the majority of which smoked cigarettes and cheroots. 5.2% were using smokelesstobacco, mainly in the form of betel quid with tobacco. Overall, 33.3% of students reported that people smoked in their presence on one or more days during
the past seven days. 31.8% of current tobacco users who bought any form of tobacco in a store were not refused purchase because of their age. 27.7% smokers
reported that they have the desire to quit. Nearly 90% of the students reported to be taught dangers of smoking and effects of using tobacco during this school
year. 91.9% of students had seen or heard anti-smoking messages from television and radio whereas 67.2% students had seen any advertisements for cigarettes
on billboards during the past month.
Conclusion: The study has shown that prevalence of tobacco use among the 5th, 6th and 7th graders of Myanmar students was lower than the prevalence of tobacco
use among 8th,9th and 10th graders (2007 Myanmar GYTS results). Exposure to second-hand smoke still remains high both at home and in public places.
Myanmar School Tobacco Control program should strengthen all schools to be 100% tobacco-free. School policy on tobacco control should be adopted andimplemented as a joint effort between the Ministry of Health and the Ministry of Education. Strengthening of existing legislation on smoke-free environments isstrongly recommended to reduce hazards of exposure to second-hand smoke.

P-S10-19

Usefulness of a Brief Street Campaign to Promote Smoking Cessation by Using Premiums and Videos

Hiroyasu MURAMATSU
Central Medical Clinic(Background)・Japan lags greatly behind other countries in adopting policies that promote smoking-cessation. One of the reasons for this may be that many non-smokers do
not recognize the dangers of passive smoking.
・Teaching the dangers of passive smoking to both smokers and non-smokers is believed to be extremely important.
(Purposes)
・Shape public opinion in favor of policies that promote smoking cessation by informing both smokers and non-smokers.
・Create opportunities to educate and inform even those people who would not participate in lectures for smoking cessation.
(Method)People who answered a questionnaire were given opportunities to take part in a lottery to win prizes. Using this approach, we persuaded subjects toagree to take part in a questionnaire and view some videos that provide a 5-minute explanation of the hazards of smoking and passive smoking. After receiving
the explanation, participants were asked to choose their degree of understanding. They were also asked if they thought about quitting smoking (or thought about
encouraging making someone quit smoking).
(Results)
・We succeeded in educating 165 persons about the dangers of smoking and passive smoking by using premiums and videos.
・About 90% of them understood the dangers and the hazards of smoking and passive smoking by the brief campaign.
・Compared with one-hour lectures, the brief campaign was less effective in motivating people to quit smoking (or thought about encouraging making someone
quit smoking).
(Conclusion)
・We were able to provide opportunities to educate and inform those people who would never take part in lectures for smoking cessation.
・Compared with one-hour lectures, the brief campaign was less effective in motivating people to quit smoking, but was still effective to inform and educate
them about the hazards of smoking and passive smoking.

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P-S10-20

Trend of Tobacco Use & Cessation Training among Third-year Medical Students in Thailand Using Data from the Global
Health Professions Student Surveys (GHPSS)

Suthat RUNGRUANGHIRANYA, Chatchai EKPANYASKUL
Srinakharinwirot University
Background: Physicians have been considered to play a pivotal role in helping their patients to abstain from tobacco use. However, reports consistently showedthat only 1/3 of Thai physicians assisted their patients to quit smoking, despite of several campaigns. Medical students are, therefore, another critical link in
tobacco control. This study is to determine changes in the prevalence of tobacco use among 3rd year medical students in Thailand and their training in cessation
based on Global Health Professions Student Surveys (GHPSS) in 2011 compared with 2006.
Methods: Two rounds of GHPSS were conducted among 3rd-year medical students nationwide in 2006 and late 2011. Prevalence of current cigarette smoking
and use of other tobacco products, along with cessation training were recorded & compared.
Results: From August to December 2011, total of 2,249 third-year students from 18 medical schools nationwide were given GHPSS questionnaires during theirregular classes. 1,837 students (81.7%) participated the survey. 43.3% were male. When compared to the 2006 survey, overall prevalence of tobacco use rosesignificantly. 355 of them (19.3%) reported to have ever used any tobacco products, which is significantly increased from 15.7% in 2006 (p=0.02). Althoughcurrent cigarette smoking remains unchanged (2.6%), the use of other tobacco products appeared to dramatically rise (2.1% in 2011 vs 1.0% in 2006; p=0.03).
There was significant improvement in cessation training in 2011. More than 1/3 of students (36.9%) reported having received training during their classes,
which increased significantly from 20.9% in 2006 (p<0.001). No changes in teaching students to take their patients’ tobacco use status as part of medical history(75.4% vs 77.2%;p=0.27). Most students had already known about nicotine replacement therapies (83.3% vs 82.9; p=0.78). Most importantly, increased numberof students had learned about using antidepressants to support tobacco cessation (60.7% vs 49.3%; p<0.001).
Conclusions: Although cigarette smoking prevalence appeared unchanged, other tobacco products besides cigarette became more popular among Thai third-year
medical students. More actions from all responsible individuals are urgently needed to control this rise. In addition, there is an imperative need to further improvecessation training for medical students in Thailand.
Funding: This study was funded by project grants from Tobacco Control Research and Knowledge Management Centre (TRC) and Thai Physician Alliance
Against Tobacco (ThaiPAT).

P-S10-21

Impact of Major Floods on Smoking Behavior and Nicotine Dependence

Suthat RUNGRUANGHIRANYA, Suthee RATTANAMONGKOLGUL
Srinakharinwirot University
Background: In 2011, Thailand experienced the most devastating floods in our history. Whilefloods cost more than 1.4 trillion baht lost, tobacco industries gained higher sales in Thailand
during the crisis. It is, therefore, unclear what impact major floods would have on the smoking
behavior and nicotine dependence among victims.
Methods: Smokers living in NakonNayok province were interviewed using a 51-item
questionnaire, including demographic data, severity of floods, Fagerstrom Test for Nicotine
Dependence (FTND), smoking behavior, and major depression score. The interviews took placefrom April till July 2012.
Results: Of 2,304 participants, 1,212 were flood victims. Half of them suffered from flood levels
between 50 cm and 100 cm, causing moderate to severe damage from the floods. Victim group had
significantly higher major depression score than the non-victim group (2.39 vs 1.55; p<0.001).
Although only 15.8% smoked >20 cigarette per day, ¾ of them smoked their first cigarette within
30 minutes after awakening. When compared to non-victim group, their mean FTND score
was higher (4.18 vs 3.89; p<0.001). After floods, their FTND score rose significantly to 4.68
(p<0.001). Most smokers changed their behavior by reducing the daily number of cigarettes, andsmoking the first cigarette earlier after awakening (table 1).

Table 1: Odds ratios showing the impact of flood on nicotine dependence & each
item of FTND score
Individual item of
FTND

Changes of FTND
score among victims

VictimGroup(n=1,212)

Number of daily
cigarette smoked

Remained low ordecreased
Remained high orincreased
Remained low ordecreased
Remained high orincreased
Remained low ordecreased
Remained high orincreased
Remained low ordecreased
Remained high orincreased
Remained low ordecreased
Remained high orincreased
Remained low ordecreased
Remained high orincreased

1005 (89.50%)

Time to smoke 1st
cigarette after
awakening
Difficult to refrainfrom smoking
Smoking during thefirst hour more
frequently
Hate to give up thefirst cigarette
Smoking even beingsick

118 (10.50%)
307 (27.90%)
795 (72.10%)
810 (73.90%)
286 (26.10%)
797 (76.40%)
246 (23.60%)
435 (43.30%)
569 (56.70%)
980 (91.00%)
97 (9.00%)

Nonvictim
group(n=1,092)
1019(93.70%)68 (6.30%)
415(38.10%)674(61.90%)892(82.10%)195(17.90%)959(88.10%)129(11.90%)274(25.20%)814(74.80%)1028(94.40%)61 (5.60%)

Adjusted ORs*
(95%CI)1
1.9 (1.38-2.62)
1
1.49 (1.24-1.80)
11.49 (1.20-1.84)
1
2.09 (1.64-2.66)
10.47 (0.39-0.57)
1
1.38 (0.97-1.96)* Adjusted for age, sex, education, depression score

Conclusions: Although floods significantly raised FTND score among victims, they
influenced each item of FTND score differently. Most of them changed their behavior
by reducing the number of daily cigarette, and shortening time to smoke their firstcigarette.
Funding: This study was funded by project grants from Thai Health Professional Alliance Against
Tobacco (ThaiPAT) & Thai Health Promotion Foundation

P-S10-22

Building Tobacco Control Capacity at the Village Level in India

Rajashree S. KADAM, Devika M. CHADHA, Jayshali B. TAMBE
Salaam Bombay Foundation
Background and Objectives: India’s Global Adult Tobacco Survey reveals that while cigarette smoking prevalence is higher in urban areas, that of all othertobacco products is higher in rural parts. Second-hand smoke (SHS) exposure at home is higher in rural areas (58%) compared to urban areas (39%). Salaam
Bombay Foundation (SBF) in collaboration with Ambuja Cement Foundation (ACF) as its local partner, designed a program for villages of Chandrapur district inMaharashtra, with an objective of initiating tobacco control activities through a self-sustaining, replicable, capacity building program targeting teachers, village
health functionaries (VHF), local government, youth and local NGOs to work towards tobacco-free schools and villages.
Methods and Descriptions: Need assessment in nine villages revealed 38.5% villagers used any form of tobacco. Some bought tobacco products on credit
with loans of up to USD 40-45. Trainings were conducted for health workers and teachers. Four-day training was done for 24 health workers (tai’s), who work
under ACF at community level and conduct sessions with families. An elder sister, who gives advice and whom one looks up to, is often called ‘tai’ in rural
Maharashtra. A similar but separate workshop was conducted for 18 teachers from seven local government schools. The criteria for ‘tobacco-free schools’ and‘tobacco-free villages’ were included in the trainings. Manuals, booklets and flipcharts on tobacco control issues were developed for teachers and health workers.
CDs and posters were developed for visual dissemination of anti-tobacco messages.
Results: The program reached 15,324 people within 20 villages and 1,633 children in 11 schools. Health workers gained confidence in tobacco control to work
as trainers. Three schools became tobacco-free. One of the villages also became tobacco-free through proactive initiative of village council president. In anothervillage, the president took initiative for creating tobacco-free schools by writing a letter to “Tanta Mukti Samiti” (committee for peace). Recently ACF merged
this program within their health project and replicating it in 60 villages. Pre-program evaluation in one of the villages in 2007 revealed that 72.5% villagers used
tobacco. One year post-program evaluation revealed that 5% quit and 45% attempted to quit tobacco. In another village, pre-program evaluation in 2007 showedthat 41% villagers used tobacco. One year post-program evaluation revealed that 6.6% villagers quit and 33.3% attempted to quit.
Conclusion: A comprehensive rural tobacco control program designed keeping the local culture in mind and involving all stakeholders promises sustainability,
program effectiveness and acceptability.

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P-S10-23

Smoking in the Seas: Tackling Smoking Prevalence among Navy Recruits

Khartika M. SHARIF, Vasuki UTRAVATHY, Vijayalakshimi KARUPPIAH
Health Promotion Board
The prevalence of smoking among Singapore residents aged 18 – 69 years rose from 12.6% to 14.3% between 2004 and 2010. A significant contributory factor
to the rise was the prevalence of smoking among males aged 18 to 29 year olds (25.3%). Singapore male citizens aged 18 to 23 years must serve the nationfor 2 years as part of the National Service programme, in the military, police or civil defence forces. Given the high prevalence of smoking among young maleadults, this is a potential demographic target for HPB to focus its tobacco control efforts. Literature also confirms that relative to non-smokers, servicemen who
smoke are more likely to miss duty days because of illness, are less productive, sustain more injuries during training and perform worse on physical fitness tests,
in turn, affecting their overall combat effectiveness. Hence, promoting a tobacco-free lifestyle among servicemen will assist the uniformed groups in grooming
officers who would be fitter and operationally ready to protect the nation. The Singapore Health Promotion Board partnered the Republic of Singapore Navy tocustomise an in-camp smoking intervention programme for its smoker recruits aged 18 to 23 years old. The programme sought to encourage smoker recruits tocontemplate quitting smoking and included hands-on coping and motivational strategies to encourage recruits to quit smoking.A pre-workshop questionnaire
was administered to 23 recruits on the first day of enlistment, of which 10 were found to be smokers. 40% of them had tried quitting in the last 12 months.
62.5% of the smoker recruits surveyed cited “poor stress management” as the reason for not being able to quit smoking. All 10 recruits indicated that they were
not interested in receiving assistance to quit smoking.All 10 smoker recruits were channelled to attend a 6-week smoking intervention workshop, each session
lasting 1.5 hours. Despite being unmotivated to quit smoking at the beginning, 90% of the participants indicated that they had cut down on the number ofcigarettes smoked by the end of the 6-week programme and that they were more motivated to quit smoking.Medical Officers would also be trained to provide
support and opportunistic smoking cessation advice, in addition to dispensing Nicotine Replacement products, at opportune moments such as during check-ups,
when recruits report sick, etc. This pilot lends credence to introducing a comprehensive tobacco control programme comprising intensive smoking cessation
workshops and opportunistic support by officers in Singapore’s National Service.
Two topics which best express the contents of the abstract‐Specific population (youth, male)‐Cessation

P-S10-24

Parental Advisory Program: The Effort to Reduce Smoking Behavior at Home

Walidatul L. MARDLIYAH, Mochamad I. NURMANSYAH
State Islamic University Syarif Hidayatullah of Jakarta
The major contributor to the occurrence of chronic diseases and poorness in Indonesia is smoking behavior. The impact of smoking is not only the smoker but
also the people who do not smoke exposed to secondhand smoke are also affected. Meanwhile, the prevalence and consumption of cigarettes in Indonesia havemeaningly increased. Assessment of Demographic Institute Faculty of Economics, University of Indonesia said that the poorest households expendituring to buy
cigarettes reached 57%. Based on data of basic medical research (Riskesdas) 2010, it was known that prevalence of smoking in Indonesia reached 34.7 % with thehighest number occurred in the age group 25-64 years. Various factors influencing the attitude of a person’s behavior, including the attitude of family members.
The family is the smallest part of the community. This paper aims to help solving the problem of smoking behavior in Indonesia through the empowerment of
the parental roles. The draft Program suggested to reduce smoking behavior is formation of Parental Advisory Program. The program consists of Knowledge
Improvement Program through explaining the dangers of smoking and secondhand smoke for family members; Skill Improvement Program through creating
the transparent communication and building the good values between family members; and Reducing Smoking Behavior Program through being anti-smoking
parenting model, making the policy of no-smoking home, pay fines for smokers in the family, and teaching the ability to refuse a friend`s invitation for smoking.
This program can be designed by Ministry of Health. Knowledge Improvement Program must be implementated by community health centers and families whoare implementating the program will be awarded by health department. The offered Formation of Parental Advisory Program is expected to be a consideration
for health agencies in order to encourage and support all parents to contribute on problem solving of smoking behavior as a form of efforts to increase the degreeof public health status at the local area.
Keywords : Smoking, Reduce, Parental Advisory Program

P-S10-25

Smoking-Related Cognition, Secondhand Smoke Exposure, the Awareness of Smoking and the Effects of Anti-Smoking
Education for Fifth and Sixth Grade Elementary School Children

Koji INAGAKI1,6,15,16, Hidehiko KAMEI1, Toshihide NOGUCHI1, Ichizo MORITA1, Shigeharu IEDA1,13, Takeshi ISOMURA3,6,12,13,16, Kimiko UOZUMI4,13,Isao OHSAWA5,16, Chie TANIGUCHI5,12,13, Yukinobu YAMAGUCHI6,13, Masako KITADA7,13, Akira ENDO8,13, Tetsuya OTANI9,13, Chiharu YOSHII10,13,
Masato KANO11,13
Aichi-Gakuin University1, Chukyo University2, Reset Behavioral Research Group3, Omoteyama Clinic4, Nagoya Medical Center5, Network for adolescence6,
Sapporo Gakuin University7, Endo Children Clinic8, National Research Institute9, University of Occupational and Environmental Health10, Shin-nakagawa
Hospital11, KTSND12, Aichi Association for Tobacco-free Kids13
Objectives: Exposure to household secondhand smoke (SHS) at home causes serious health risks to children. The purpose of this study was to assess smokingrelated cognition, SHS exposure, the awareness of smoking and the effect of anti-smoking education for elementary school children in Aichi prefecture. Methods:
We have conducted a questionnaire survey, which included the Kano Test for Social Nicotine Dependence for youth (KTSND-youth) to children. In this crosssectional school-based study, a total of 1,437 fifth and sixth grade elementary school children (aged 11-12, 700 boys, 737 girls) in 11 elementary schools from2008 to 2012 completed the questionnaire. The KTSND-youth was reevaluated following anti-smoking education. Results: The prevalence of self-reported
exposure to SHS at home, children who wanted to smoke, those who had experienced smoking, those who knew of the harmful effect of smoking or SHS, those
who knew about nicotine dependence, and those who knew of the harmful effect on exercise and a decline in learning ability was 60%, 3%, 2%, 98%, 88%,89%, and 71%, respectively. The score of KTSND-youth significantly decreased from 5.1 ± 4.2 to 3.2 ± 3.4 after did the anti-smoking education (P < 0.01).
In addition, boys demonstrated higher KTSND-youth scores than did girls (boys 5.4 ± 4.4; girls 4.8 ± 3.9, P < 0.05). The score of KTSND-youth for children
exposed to SHS at home were higher than those not exposed to SHS at home (SHS 5.4 ± 4.3; no-SHS 3.5 ± 3.6, P < 0.01). Conclusions: This study showedthat anti-smoking education helped to decrease the KTSND-youth score and the prediction of initiation in future smoking significantly. Anti-smoking educationfrom elementary school age and support of smoking cessation for family members might be important for decreasing social nicotine dependence among juniorhigh school students, resulting in the prevention of students from making smoking transitions. This study was supported in part by a Grant-in-Aid for Scientific
Research from the Japanese Ministry of Education, Science, Sports and Culture (No. 23593079) and the 2012 Funds of Aichi Health Promotion Foundation.

176

P-S10-26

The Association Between Second-hand Smoke Exposure, Knowledge and Willingness to Perform Smoke-free Rights ofNon-smokers in Guangzhou

Yi YANG, Kai-liang CHENG, Jun LIU, Xiao-hua YE, Lei CHEN
Guangdong Pharmaceutical University
This study was supported by the Bloomberg Initiatives (No.China-3-02).
Objective On 1 September 2010, the Guangzhou Tobacco Control Regulations (the Regulations) was implemented. The citizens were endowed the smokefree rights in public places which prohibited smoking by the Regulations. This study explores the association between second-hand smoke (SHS) exposure,knowledge, awareness of smoke-free rights and willingness to perform the rights of non-smokers in Guangzhou, Guangdong Province.
Methods: A cross-sectional survey was conducted in Guangzhou using a stratified multi-stage cluster sample design. Five thousand one hundred thirty-fivecitizens aged 15 years or above were administered a face-to-face interview that obtained information about smoking, SHS exposure, SHS-related knowledge (7items), awareness of smoke-free rights, willingness to perform the rights in 2011. SHS exposure refers to non-smokers’ inhalation of smoke from the exhalationof smokers at least 1 day (≥15min) per week. A total of 4,239 non-smokers were included in the data analysis. Chi-square tests were used to compare the SHS
exposure and related factors. Correspondence analysis was used to examine the association between SHS exposure and willingness to perform the rights.
Results: Among the 4239 respondents, 1425 (48.98%) were male, the mean (SD) age was 41.92(17.02) years. The self-reported SHS exposure rate was 46.99%.
The prevalence of SHS exposure was 48.95% for man, 45.98% for woman (P>0.05). The median score of SHS-related knowledge was 6 (total score was 7).
There was no statistically association between SHS exposure and knowledge (P>0.05). SHS exposure was significantly associated with awareness of rights, andwillingness to perform rights. Correspondence analysis showed that awareness of and willingness to perform rights was related with no SHS exposure; awarenessof, but unwillingness to implement rights was associated with low exposure (1~3 days/week); unawareness of the rights was related with high exposure (4~7days/week).
Conclusion: Propaganda should focus not only on SHS-related knowledge, but also on the Regulations. Interventions to promote awareness of and willingness
to perform the smoke-free rights in public places may reduce or avoid the SHS exposure.
Key words: SHS exposure; Tobacco control; Smoke-free rights; Correspondence analysis

P-S10-27

Smoke, Smoking and Cessation: The Views of Children with Respiratory Illness

Marewa GLOVER, Anette KIRA, Julienne FALETAU
University of Auckland
Aim: to explore the attitudes of Māori and Pacific children with respiratory illness towards second hand smoke (SHS), smoking and parental smoking cessation.
Method: Twenty-seven Māori and 13 Pacific children (aged 6-11) in New Zealand were interviewed (7 individually, 34 in focus groups). They were asked:
their attitudes towards smoking; how SHS affects them; their fears and concerns about smoking for themselves and their parents; how to reduce their exposure
to smoking; and their experiences asking parents to quit smoking. The interviews were transcribed, entered into NVivo and analysed using a deductive approach.
Results: The children said SHS made them feel “bad”, “unhappy”, “angry”, “uncomfortable”, “annoyed” and “really sick”, making them want to get away fromthe smoke. They were aware of the negative consequences for themselves and others: “I think that it’s bad to smoke”, and “it is not right to smoke and I don’t
like it”. They knew about some harmful effects of smoking: “it [smoking] is dangerous” and that “you could die from it”. Many children had fears for people
around them who smoked.
Families reportedly had rules restricting smoking around children: “You’re not allowed smoke in the car where babies are”. Most children reported that adults
complied with those rules: “they just go to the back and don’t smoke around us”, and “they never smoke around me”. However, a number of children reported
that people still smoked around them.
The children had experienced people around them quitting. The most common reason perceived for people quitting was concern for children. Other reasons
included money, TV ads and workplace policies. There was an awareness of how difficult it is to quit smoking.
Whilst some children thought family members supported others to quit, others said there was no one to help. A lot of the children thought they could ask parents
to quit with a few suggesting they could “act like I’m sick” thus playing on the concern of parents.

P-S10-28

Outreach Activities for Tobacco-Free Carried out by Medical Students

Urara SAITO, Kotaro TAKEBE, Tatsuro OAKU, Yosuke TARUMI, Akira SAKAMOTO, Shinji TOMOTA, Takatoshi FUJITO, Hirofumi SUZUKI,
Yuriko KONDO, Masako SHIGETA
Kyoyo Prefectual University of Medicine[Background and Purpose] Youth and young adults are the most important group for a target in tobacco-free activities and for participants of the activities. There
are many youth advocacy programs in Western countries such as Kick Butts Day but in Japan regular youth activities have not been conducted. Considering thesituation as weakness of tobacco-control in Japan, Kyoto Association for Tobacco Control (KATC) and Kyoto Prefectural University of Medicine encouraged theparticipation of medical students who learn the causal association between smoking and illness and communication methods. A substantial number of medical
students participated in the activities. We review the activities in chronological order and evaluate the benefits and feasibility.
[Methods and Result] Medical students started participating in the school-based outreach activities so called “Tobacco Free Caravan in Kyoto” in 2004. At
first medical students attended the workshops for the practical education of social medicine. Some students who were interested in the activities participatedvoluntarily using their free time in 2005. Gradually medical students devised ways of communicating effectively with quiz, educational material and presentation
slides. Since 2007 medical students have performed the role of presenter and central character. The number of medical students involved was 4 person (4schools, 10 times) in 2004, 7(9, 15) in 2005, 10(7, 14) in 2006, 9 (23, 45) in 2007, 21(31, 74) in 2008, 21 (29, 65) in 2009, 27 (56, 140) in 2010, 22(33, 75) in2011 and 23(47, 77) in 2012. The high school students tended to be more interested in the contents presented by medical students than professions. The medical
students acquired basic understanding health promotion and basic communication skills. From 2009 to 2011, medical students were entrusted with organizing
the Tobacco-Free Caravan on the World No Tobacco Day in a shopping mall close to Kyoto Station. Medical students were organizing committee to recruit staff
and to prepare the event with nursing students. On the day of the event we (15 medical students in 2009, 13 in 2010 and 11 in 2011) set up the site and worked
as presenters and performers. The events attracted large crowds (500~1000 people) and the guests really enjoyed a tobacco quiz and prizes. Over 100 smokers
participated in measurement of CO every year and over 20 smokers expressed their determination to quit smoking.
[Discussion and Conclusion] Medical students are expected to take a position on leaders and activists in outreach activities for tobacco-free. These activities are
considered effective to both promote tobacco-free in community and to educate medical students. However the number of medical students involved remains
restrained because of rigidness of the curriculum. Participation in these activities should be part of core curriculum.

177

P-S10-29

The Relationship between Tobacco-Control Status and Smoking Behavior Among Students at 81 National Universities inJapan

Kitada MASAKO1, Musashi MANABU2,4, Yoshino KEIKO3,4
Sapporo Gakuin University1, Hokkaido University2, Utsunomiya University3, Japanese National University Council of Health Administration Facilities4
Object: The aim of this study is to clarify the relationship between what status tobacco control measures is in 81 natural universities and smoking behavior
among university students in order to promote a tobacco-free policy.
Method: We referred to their official websites to search for the keywords of tobacco -free campus, smoke-free, and tobacco control until 2013.
Results: The survey found that only 21.0% (17 universities) had implemented entirely tobacco-free policy, 50.6% (41 universities) had implemented indoor
tobacco-free policy (smoking areas are set on campus), and 19.8% (16 universities) had implemented partially tobacco-free policy (some indoor areas are smokefree). 30 out of 40 universities that have university hospital have implemented entirely tobacco-free policy. Additionally, this survey showed that universities orcolleges that include medical and/or educational department(s) tend to provide entirely tobacco-free relatively.
Discussion: Twenty percent of universities have made campus entirely tobacco-free. Those with medical department or university hospital, and/or education
department have implemented entirely tobacco-free campus earlier. However, non-medical and/or non-educational departments tended to remain only indoor
smoke-free policy.
Conclusion: The study indicated that many universities had addressed tobacco issue. However, the level of control varies due to differences of educational aims
and social responsibility. Every campus at universities and colleges should adopt a tobacco-free policy to protect students and staffs from exposure to secondhand
smoke. Realizing tobacco-free campus, we should promote tobacco-free measures in responsible for students’ health and educational initiatives.

P-S10-30

Challenges in and Measures against Workplace Smoking in Yamagata Prefecture’s Administrative Offices

Atsuko KAWAI1,2, Yoko MATSUNAMI1,3
Nanyou&Higashi Okitama Medical Association1, Social Medical Corporation2, Yamagata University3
Background: Since prevention of passive smoking was established in law in 2003,
in the Health
Promotion Act,
Article25, thewith
importanceprovidingsmokeSchool-level
and county-levelfactors
associatedsmokingof
among
middlefree workplaces has increased. Although more inside work environments are becoming
smoke-free,
there
are
many
practical
diffi
culties
implementing
thepolicyschool students
in all work environments, including outside areas.
Song-Lih
Huang,
Yu-Yun
Hung,
I-Fen
Lin
Purpose: This investigation aimed to clarify the current state and problems of smoke-free workplaces in administrative offices in some areas in Yamagata
Institute of offi
PublicPrefecture in order to develop a way to promote smoke-free work environments in government
ces.Health, National Yang Ming University, Taipei, Taiwan
Method: A questionnaire was distributed to all employees working at administrative offices in two towns and one city in Yamagata Prefecture(N=784). The
questionnaire survey was administered between March 2011 and February 2012
through local
government
agenciesby Nanyou&Higashi
OkitamaObjective:
To identify
school-level
and county-levelfactors associatedwithMedicalsmoking
Association and completed questionnaires were received from 736 respondents. The survey was supported by a Yamagata Prefecture Medical Association healthbehavior among middle school students.
research project. The questionnaire asked about sex, age, occupation, smoking status, and attitude toward a smoke-free building, and it also contained the Kano
Methods: We used the 2010 Global Youth Tobacco Survey data from Taiwan,
Test for Social Nicotine Dependence (KTSND).
Result: Men accounted for 67% of the respondents and the most common occupation
wasamong
generalclericalstaff with(69%).
Concerning
status,49%
conducted
middleschools,
15,999students smoking
in 183 schools
from
20 werenever smokers, 23% past smokers, and 22% current smokers (who smoke everyday). As forsupportforcounty).
a smoke-freeworkplace,that anbyoutsideadministrative
areas(city orSchool-levelvariables38%
werefelt
generatedsmoking area should be preserved, 20% thought it should be a smoke-free workplace, 21% were hopeful it would become a smoke-free workplace, and 20%
aggregating individual data. City/county level variables were obtained from other
did not mind. Many who thought that an outside smoking area should be preserved were passive toward a smoke-free workplace and had high KTSND scores,
surveys. Multilevel logistic regression was used to estimate the risk of smoking withinregardless of smoking status.
30 days;odds
ratio
presented
the following
table. (* =workplacestatistical significance)
Conclusion: The results suggest that among both smokers and non-smokers were
those
who
were
passiveintowarda smoke-free
and who lacked
awareness of smoking and passive smoking. These are among the reasons why theResults:
smoke-freeproject
has notin these
locations.
Assistanceis required
Aftercontrolling
forproceeded
individual factors
such
as grade,parent smoking,to provide employees specific information to improve their recognition of the needfor a attitude
smoke-freeproject.
positivetowardsmoking, school factors including the prevalence of parent
smoking, and the proportion of current smokers who had smoked in school, werepositively associated with smoking. Among the area variables, percentage of parent
living together was negatively associated with smoking, while parent education level
P-S10-31 School-level and County-level Factors Associated with Smoking among Middle School Students
and average income was not significantly associated with current smoking.
Song-Lih HUANG, Yu-Yun HUNG, I-Fen LIN
Conclusion: The school parent smoking rate was a significant factor, and strict
National Yang Ming University
school regulation was associated with less smoking. Social coherence of the larger
environment,
represented
by theschool
percentageof parents living together in the county
Objective: To identify school-level and county-level factors associated with smoking
behavior
among middle
students.
Methods: We used the 2010 Global Youth Tobacco Survey data from Taiwan, conductedamongschools,
withadolescent
15,999 students
level, seemed
to bemiddle
associatedwith lesssmoking.in 183 schools from 20
administrative areas (city or county). School-level variables were generated
Table: Factors associated with smoking within 30 days.

by aggregating individual data. City/county level variables were obtained
from other surveys. Multilevel logistic regression was used to estimate therisk of smoking within 30 days; odds ratio presented in the following table.
(* = statistical significance)
Results: After controlling for individual factors such as grade, parent
smoking, positive attitude toward smoking, school factors including theprevalence of parent smoking, and the proportion of current smokers who
had smoked in school, were positively associated with smoking. Among thearea variables, percentage of parent living together was negatively associatedwith smoking, while parent education level and average income was not
significantly associated with current smoking.
Conclusion: The school parent smoking rate was a significant factor, andstrict school regulation was associated with less smoking. Social coherenceof the larger environment, represented by the percentage of parents living
together in the county level, seemed to be associated with less adolescentsmoking.
Table: Factors associated with smoking within 30 days.

178

Boys (n = 8153)

Girls (n = 7846)

9th grade vs. 8th grade

0.68*

0.77*

8th grade vs. 7th grade

0.86*

1.26*

Positive attitude to smoking

3.40*

2.71*

Parent smoking

2.18*

2.87*

Parent smoking rate (every 10%)

1.29*

1.26*

% Smokers ever smoked in school (high vs. low)

1.37*

1.27

Average disposable income (every 10,000 NT)

0.997

0.994

% Parent education above college (every 10%)

1.01

1.02

Parents living together (low vs. middle & high)

1.31*

1.25

Personal

SchoolCity/County

P-S10-32

Four Years of National Tobacco Control Programme in India: a Critical Review

Ravinder KUMAR, Pranay LAL, Rana J. SINGH
Tobacco control
Background: India launched its National Tobacco control programme (NTCP) in 2007-08 in 9 states (18 districts) and 12 states (24 districts) in 2008-09 with theobjectives to create public awareness about the harms of tobacco use and institutionalise enforcement through effective implementation of national legislation.
The present study was conducted with the objectives to review the programme critically and identify the challenges.
Methodology: Secondary data analysis and interviews of NTCP staff on semi-structured questionnaire was done in 2010 and 2011.
Result: Mass media campaigns, capacity building, GATS India survey and establishment of toll free helpline number were few of key activities done at national
level. All states except one has established state tobacco control cell and steering committees at state and district steering committees. Enforcement mechanism
established in 17 states (80%). 29 out of 42 districts have tobacco cessation facilities in district hospitals. Few objectives are yet to achieve, the product testinglabs could not be established. Huge capacity building needs. NTCP is still a vertical program.
Challenges
Competitive inter-ministerial interests, large workforce employed in tobacco sector and plethora of tobacco products keep posing challenges to NTCP.
Conclusion: Despite all constraints, NTCP has resulted considerable rise in public awareness about harms due to tobacco use. Key stakeholders have been
sensitized to take the issue further.

P-S10-33

Ensuring Tobacco Control Law Implementation through GO-NGO Capacity Building

Ishrat CHOWDHURY
International Union Against Tuberculosis and Lung Disease
Background: Exposure to secondhand smoke (SHS) is a risk for contracting diseases. Protecting people from SHS is possible only through effective
implementation of tobacco control. But tobacco Control law implementation is a big challenge in Bangladesh for various reasons. It is documented that lackof coordination, collaboration and common understanding among Government & Non-governmental organization (NGO) at local to national level hinders
enforcement of Tobacco Control law. Activation of task forces for tobacco control law implementation, monitoring law violation scenario, remove illegal
advertisements and ensure smoke-free through mobile courts is often challenging. So bringing both parties in a single platform is inevitable for creating asmokefree country.
Methodology: Capacity building of government and non-government organizations is a strong tool for successful monitoring of law violation and its
implementation. The Union (International Union Against Tuberculosis and Lung Disease) and its grantee organizations offer different capacity building trainings
for government and non-governmental organizations on tobacco control, particularly in law implementation.
Results: The Union organized several capacity building workshops & trainings for senior government officials and NGOs professionals on various issues related
to tobacco control. 106 participants attended 05 courses in last one year. NGOs also organize trainings for taskforce committee members, other local government
personnel, media professionals and owners of public places and public transports. These capacity building workshops helped to build GO-NGOs relationship andable to come to common understanding on current challenges of TC law implementation. These workshops also increased organizational strength on project &financial management. Those also assisted participants to share their experiences and enriched themselves on tobacco control issues.
Conclusion: Developed working relationship among Government and NGOs, support the tobacco control programme especially in activating task forces for
tobacco control, monitoring law violations, removing illegal advertisements and ensuring smoke-free through mobile courts which has proven to be an effective
mechanism in Bangladesh. This Government-NGO collaboration can be a model for other aspects of tobacco control as well as other development programme.

P-S10-34

Kameoka City, Kyoto, Japan Takes Up the Challenge for Making Smoke-free City with Strategies and Persistence

Masako SHIGETA1,2, Mika YAMASHITA1, Hiroko TOYOSHIMA1, Shohei YOKOTA1, Atsuko AOKI2, Takashi DOI2, Chiaki SAKAI3, Kumiko OHNO4,
Noriko IJIRI4, Tomoko OHTA4
Health Center of Nantan district1, Kyoto Association for Tobacco Control2, Sakai Dental Clinic3, Kameoka City4[Background] In spite of the great effectiveness of health, tobacco control policy in Japan has been painfully behind the world both nationally and locally.
Kameoka city has a population of 100,000 and 20% of whom are over 65 years old. The smoking prevalence was relatively high (62% among male in 1998).
[Purpose] KNHC and Kameoka city joined forces to establish the first basic guideline concerning tobacco control in 2003 and has been working on the issuesof both active and passive smoking involvement local citizens. We reviewed the process and evaluated its effectiveness.
[Methods] Kameoka city has been implementing various projects since 2003. At first, the focus was educational setting. School-based workshops for high school
students started in 2003 as the first trial in Japan. Public schools implemented a smoke-free policy in 2003 as requested by the Association of doctors, dentists
and pharmacologists, ahead of the other cities in Kyoto. In the health promotion committees of Nantan district and Kameoka city, the tobacco problem has been
discussed as a priority every year respectively. Seminars and opportunities for support for quitting have been held extensively at community-based events since2006. In 2011 Kameoka city established a new operation sheet and started various projects for smoke-free city by using novelties (Kamemaru badge and strap),
a summer seminar for kids (Tobacco sleuth), and a system of commendation for smoke-free indoors. Kamoka city has been monitoring smoking prevalence ofyoung adults using data of 3 year child health check-up.
[Results]All public schools have been following a smoke-free policy both indoor and outdoor. Two hundred and twenty schools, offices and shops werecommended as smoke-free indoors. About sixties of those decided smoke-free under the encouragement of the system. Smoking prevalence has decreased from
46.9% to 34.2% among fathers and from 15.6% to 7.9% among mothers.
[Conclusion] Community based tobacco control was working practically in Kameoka city. Our activities caused a marked decrease of smoking prevalence. We
are determined to continue constant efforts to make smoke free city.

179

P-S10-35

Implementation of Tobacco Control for Rural Communities by Primary-Care Units or Health Promotion Hospitals of
Sub-district Level in Thailand

Chanthana VITAVASIRI, S. PAUSAWADI
Commmittee and President of Thai Health Professional Alliance Against Tobacco
THPAAT provided education and training program on tobacco control for healthcare personnel in primary care units. The objective is to study outcome of the
program that lead to the implementation in rural communities. Material and Method: The project was developed into 3 steps. Step I: Between Jun 2009–Jan
2012, THPAAT organized education and training for personnel of primary care units about tobacco toxicity, cessation, counseling technique, Thai National
Tobacco Control Policy and Surveillance system. Step II: Action on Tobacco control in the rural communities. Step III: Evaluation of tobacco control in ruralcommunities. Result: During the three-year period, THPAAT project provided tobacco control education and training course for 1,726 health personnel from808 primary care units in 9 provinces. Of all those who attended, 82.8% gained more knowledge. After the training course, the personnel of primary care units
created their own tobacco control activities in rural communities. The evaluation on Jan–May 2012, THPAAT conducted two studies. The first one was “TheNational Survey on Smoke-free Primary Care Hospitals in Thailand”. The study was descriptive with 1,001 primary care unit samples. 278 hospitals returned
the questionnaires. It was found that personnel of primary care units were nurses in 50.4%, had attended basic and advance tobacco control course in 50.9%
and 45.5%. The tobacco control activities in rural communities were searching for smokers in 36.3% and providing cessation service: Ask, Advice, counsel
and follow up in 68.6%, 64.0%, 68.9% and 42.1% respectively. It was recommended that implementation of tobacco control in rural area required more humanresource development. The second study was “Role of Thai Nurses in Tobacco Control”. It was descriptive, with stratified random sampling 893 nurses. 654
nurses responded the questionnaires. The result showed that Thai nurses had activities in tobacco control in low level. Nurses in primary care units performed
cessation service mostly by asking, but with least following up. It was concluded that Thai nurses need more development of skills and knowledge of tobacco
control. Conclusion: Tobacco control education and training course of personnel in primary care units will affect proactive tobacco control in rural communities
but the implementation is still not covered nationwide. THPAAT should extend the training courses to all 76 provinces.

P-S10-36

Predictors of Smoking Behavior among Female Students of High Schools and Vocational Education Colleges in NorthEastern Thailand

Ratchanee VEERASUKSAWATT, Nuanjan PRAKENREE, Wanpen DUAGMALA, Wantanee THONGNUN, Parichat JAISUPAP,
Pougthong TRYCHASIRIKOSOL
Sanpasithiprasong HospitalObjective: The study aimed to evaluate predictors of smoking behavior among female students of high schools and vocational education colleges in NorthEastern Region of Thailand.
Materials and Method: It is a cross-sectional survey research. The sample size was calculated by estimating proportion of smoking female students andrandomizing by multistage random sampling. The self-administered questionnaires developed by the researchers containing the context of Ajzen’s theory ofplanned behavior, attitude, subjective norms, and perceived behavioral control. The validity was tested by three experts and the reliability test was performed
with the Cronbach value of 0.73. Percentage, and regression entry method were used in data analysis. There were 2,900 questionnaires.
Results : It revealed that overall prevalence of cigarette smoking was 8.1 percents. The majority was vocational college students. The most common predictorof smoking among female students was perceived behavioral control, followed by negative attitude toward smoking respectively. Whereas, subjective norm wasrarely used as the predictor in the study.
Conclusion : It was suggested that adolescents were a high risk group for cigarette smoking who should be closely monitored. Anti-smoking campaigns should
be started at the earlier age to adjust the attitudes toward smoking behavior, promote living skill, develop self-confidence and self-control to avoid risk behaviorof cigarette smoking. The adolescents who were at risk should be encouraged to use their leisure time appropriately, and participate in anti- smoking campaign
activities.
Key wards : Predictors of smoking behavior High Schools Female Students
Vocation College
Corresponding author : Veerasuksawatt R., Psychiatry Department .Sanpasitthiprasong Hospital .
Ubon Ratchathane,Thailand.34000 . Tel. 045-255848 ; 0817902209 . Fax : 045-244145, 045-254392
Email: Ratchanee26@gmail.com.

P-S10-37

Study of the Smoking Preventive Education in the Teacher Training

Hiroko ISODA
Sonoda women’s University
Yogo teacher is a health advocate school. Yogo teacher is Japan's unique style, they have been brought up to protect the health of the child as a health promoting
school. They were been brought up to protect the health of children in their own styles and Japan. Teachers will need to provide a healthy and safe environment
for children, smoking prevention education is particularly important among them. In order to practice the smoking prevention education in schools, while still astudent Yogo teacher training institutions, it is necessary to understand the principles of smoking prevention education.
Research subject is the 36 first-year students are enrolled in the course of fiscal 2012, the Department aims to Yogo teacher. We have cooperation with theinvestigation in July 2012 about participation in research. Investigation and survey method was self-describing through distribution of questionnaires. In thisstudy, two were smokers (5.5%). In order to understand the current status of students seeking a Yogo teacher, we conducted a preliminary investigation smoking
status as a student. That students who have already started smoking in college freshman have more than one person, we have found in this study. It Guess thestudents who have been educated non smoking before college, but was more than 90%, you're smoking Nevertheless, the effect of education non smoking havebeen carried out in the school education of the current low be. I think university education in the future, there is a need to develop a new smoking prevention
programs180

P-S10-38

Changes in Perceptions on the Effectiveness of Tobacco Control Policies among Adolescents: A Prospective Study

Melinda PENZES, Robert URBAN, Peter BALAZS, Kristie Long FOLEY
Smmelweis University
Introduction: Since the early 1990s, the government has adopted many important anti-tobacco policies, but tobacco smoking still has an important negative
impact on health status of the Hungarian population. The latest anti-tobacco legislation (effective since January 1, 2012) prohibited smoking in all confined
public places. This study evaluates changes in the adolescents’ perceptions on the possible effectiveness of tobacco control policies to reduce general smoking
prevalence and assess the short-term consequences of the new legislation.
Methods: Baseline and follow-up surveys were conducted in 2010 and 2012 among students in six Hungarian metropolitan cities. At baseline, randomly selected
6th and 9th graders participated (n=2,208; 54.9% girls) while at follow-up, 8th and 11th graders completed the survey from the same schools (n=1,987; 54.0%
girls). Possible effectiveness of nine tobacco control policies as suggested by the WHO FCTC were rated by participants. Smoking status of respondents, parental
smoking and awareness of harmful health effects due to secondhand smoke were also measured.
Results: The past 30 days prevalence of smoking increased significantly (p<0.001) from baseline (25.3%) to follow-up (30.0%). According to the adolescents,
price increases, stricter regulation of tobacco products’ sales and non-smoking role models (e.g., parents) were believed to have the greatest positive impact
on smoking prevalence. Additionally, perceptions on the effectiveness of all three mentioned strategies were significantly strengthened at follow-up. Smoking
students did not perceive that the most tobacco control policies would reduce tobacco use. However, at follow-up, while controlled for gender, grade and parental
smoking, smokers indicated by significantly greater odds that school-based tobacco prevention programs (OR: 1.66, p=0.001) and promoting smoking cessation
options (OR: 1.35, p=0.015) would reduce successfully the number of smoking people. Significantly more participants (p<0.001) were aware of the harmful
health effect of secondhand smoke at the time of the newly introduced anti-tobacco legislation (83.9%) compared to baseline (75.8%), although higher odds ofawareness were shown among non-smokers compared to smokers (OR: 2.35, p<0.001). Parental smoking of respondents was decreased from 48.6% to 45.9%
from baseline to follow-up (p=0.018).
Conclusions: Understanding adolescents’ opinion about tobacco control policies is important because they are at greater risk of smoking initiation. Therefore
emphasizing the benefits of tobacco control policies must be considered when implementing anti-tobacco programs for adolescents.

P-S10-39“Tobacco Free Teacher, Tobacco Free Society” – Empowering Teachers in Rural India to Raise Awareness and Advocate
for Enforcement of Tobacco Control Law

Jayshali B. TAMBE, Devika M. CHADHA, Deepak PATIL, Rajashree S. KADAM
Salaam Bombay Foundation
Background and Objectives: India’s Global Adult Tobacco Survey revealed tobacco use to be higher in rural areas. 52% and 24% rural males and females use
tobacco compared to 38% and 12% urban males and females. Second-hand smoke (SHS) exposure at home is 58% in rural areas and 39% in urban areas. Tobacco
consumption is socially acceptable and rooted in local rural culture. Children and adolescents are the most vulnerable victims. Salaam Bombay Foundation (SBF)
decided to work in across rural Maharashtra to address high tobacco use, through the medium of teachers who are looked upon as role models. The strategy was
to sensitize teachers and convert them into change agents and implement ‘tobacco-free teachers, tobacco-free society’ concept. Program objectives were to createawareness about tobacco ill-effects, equip teachers to conduct sessions with school children, and help enforce laws preventing access of tobacco to children.
Methods: SBF met Director of State Education and District Education Officers in Maharashtra state to explain program needs and request access to their existing
master trainers, who provide training to teachers employed with state government schools on various subjects. Three-day state workshop was organized forselected master trainers, briefing them about SBF school programs and on issues in ‘tobacco control’, including Indian Tobacco Control Law - COTPA 2003.
Guidance was provided on ground level teacher training and monitoring program implementation. Each district was represented by five to six master trainers.
Trained master trainers acted as SBF contact point for each district and conducted one-day block level teachers training in their respective districts. 45 - 50
teachers from each block were trained. Block level trained teachers implemented the program in their schools and villages in presence of master trainers, throughstreet plays, songs, drawing, slogan and essay writing competitions, and rallies. Manuals on tobacco control issues were developed for various training levels.
Booklets, flipcharts, CDs and posters were developed for visual dissemination of anti-tobacco messages.
Results: SBF trained 132 master trainers, who trained 20,607 teachers from 19 districts. Monitoring of 61 schools showed that teachers implemented the program
effectively and efficiently. ‘No-tobacco’ signage was cited at school premises and there was increase in tobacco awareness as analyzed through evaluation forms.
Four schools became tobacco-free.
Conclusion: Utilizing existing resources and empowering teachers is an excellent way to spread tobacco awareness not only among students and their families
but also across communities, extending to involve local authorities.

P-S10-40

Expanding the Tobacco Control Health Network: A Hospital, School, and Police Station Project

Krongjit VATHESATOGKITThai Health Promotion Foundation
In Thailand, the hospital is the focal point in terms of providing quitting services and educating patients and their relatives about the harms of smoking. Police
officers also play an important role in enforcing smoking laws and providing students with knowledge about the consequences of smoking and using drugs.
Simultaneously, teachers play a critical role in providing learning opportunities for their students about the dangers of smoking. In thisframework, by linking
these 3 parties together through a strong working structure, they can become an integral part of the Health Professional and Non-Health Professional networks
already working on tobacco control. Recognizing this opportunity to strengthen the network, ASH Thailand began working closely with local authorities in 3
districts from 3 regions in Thailand.
As a result, hospitals, schools, and police stations in these 3 districts have adopted smoke-free policies and set up surveillance teams to enforce smoke-free
regulations in hospitals and police stations. Within a year (2010-2011), the hospital helped organize quit smoking programs in 11 schools resulting in 180 of 336
students to quit smoking (53.57%).
The follow up study found that the program helped strengthen the network in the 3 districts, and provided support for key personnel in local areas to become
functioning focal points. In total, the program was able to work closely with 54 schools and 6,036 students from grades 3 to 12. Among these students, 61.8%
indicated that they enjoyed receiving “edutainment” from the program, and 44.2% indicated that they would like to quit smoking after participating in the
program. Also, 61.7% saidthat they are now more confident to not take up smoking, and 60.5% vow to help other people quit smoking.
The next step for the program is to continue to extend the project to cover community leaders and volunteers, who play a very significant role in smoke-freehome/village projects. They are also very important focal points for the surveillance team working to protect all localities from tobacco industry tactics.

181

P-S10-41

Community Tobacco Cessation in Mumbai

Ajay PILANKAR, Devika CHADHA, Tshering BHUTIA
Salaam Bombay Foundation
Context: The tobacco habit is difficult to break especially for those heavily addicted to the substance.
Many users are unaware of the availability of professional help for tobacco cessation. The sociallydisadvantaged neither have the means nor the money to use these cessation services. Salaam
Bombay Foundation, therefore came up with a unique concept of taking the cessation service at thedoorstep of the addicted tobacco user through a “mobile community-based cessation help” service.
Methods: A “mobile community-based cessation help” service named “Life First” was launched by
SBF as a means of community based cessation model. This service consists of three components - a
cessation van having IEC (Information, Education, Communication) materials to motivate quitting,a help line number where callers can request for the “mobile cessation help” service to come at theirdoor step in communities where tobacco users want to quit, and collaborating with primary andurban health centers to carry out cessation activities. When callers request for the cessation service
to be made available to the community, the cessation van along with a qualified cessation specialist
and a doctor to screen tobacco related oral cancers would go into the community.
Results: Within a week of the appearance of the news report about “Life First”, SBF received morethan 100 calls from across the country. The individual beneficiaries will be tracked for quit attempts
and the community will be monitored as a whole for successful cessation.
Conclusion: This community-based model of tobacco cessation holds promise in making tobacco
cessation service available to the ones who need them the most without any hidden costs to thebeneficiary.

Mobile Cessation Van

IEC Materials(To motivate quitting)
Doctor(For oral cancer
screening)Counselor(Cessation Specialist)

Community in need of
Cessation Service

Cessation Help Line

Community-Based Tobacco Cessation Model

P-S10-42

Using Indian Festivals to Advocate for Tobacco Control: Innovative Ways to Reach Out to Communities andStakeholders

Tshering BHUTIA, Devika CHADHA, Narayan LAD
Salaam Bombay Foundation
Background: Festivals and occasions viz. - “Raksha Bandhan” (sister ties thread on brother’s wrist signifying brother’s commitment to protection), “Ganpati
Festival” (displaying Lord Ganesha’s idols at marquee - ‘pandals’ attracting devotees), “Dussehra” (destroying “Ravan” symbolizing new beginnings of goodover evil) provide opportunities to create awareness on social issues.
Methods: During “Raksha Bandhan” girls tied “rakhis” (threads) on tobacco vendors’ wrists, requesting not to sell tobacco to minors. Preparing for “Ganesh
Festival”, meetings with festival committee members were followed by letter to pandals requesting refusing tobacco advertisement. Anti-tobacco banners anddevotional songs were distributed to pandals, urging devotees to throw tobacco in boxes at entrances before seeking blessings. During “Dussehra”, same concept
involved destruction of effigy of “Ravan” symbolizing evil (tobacco). Children’s rallies spreading anti-tobacco messages were conducted on Independence andRepublic Day, with themes - “Quit Tobacco Movement” and “Proud to be Tobacco Free”.
Results: During “Raksha Bandhan”, of 250 vendors approached by 700 students, 63 shops were found keeping their promise of not selling tobacco to minors.
Advocacy at Ganpati pandals over past three years resulted in pandals going “tobacco-free” - refusing advertisements and making devotees leave tobacco outside
worship area. Mumbai Municipal Corporation issued circular banning tobacco linked advertising in pandals, From 81 pandals (2008), the program extended tomore than 200 pandals and 1000 young tobacco control advocates. Children performed through song, dance, and drama at 176 pandals across Mumbai (2010).
“New Year” activity started (2009-2010) as individual school activity at 13 locations, took an organized format in 2011, spreading to 1632 children from 76
schools.
Conclusion: Festival linked advocacy helps reach large populations including event organizers, law enforcers, and policy makers, generating awareness, andtobacco control law implementation.

P-S10-43

Changes of Tobacco Use Behaviors in Thai Dental Students in 5 years

Wikul VISALSETH1, Surat MONGKOLNCHAIARUNYA1, Thongchai VACHIRAROJPISAN2Ministry of Public Health1, Chulalongkorn University2
Health professions students have been found to play an important role in cessation and prevention of tobacco use in their patients. Thailand has developed
the tobacco surveillance system in dental students using the Global Health Professional Student Survey (GHPSS) which has previously been conducted in
Thailand in 2006 and recently in 2011. This study aims at assessing any changes of tobacco use in third year Thai dental students, their experiences of exposure
to secondhand smoke (SHS), their schools ‘ antismoking policy and enforcement, and their learning experiences on smoking cessation. Comparison from the 2
surveys show that within 5 years prevalence of cigarettes smoking are slightly decreased both for ever smoked cigarette (17.0 % to 13.9 %) and currently use
from 3.9 % to 2.5%.The remarkable upward changes are found in prevalence of the use of any form of tobacco other than cigarettes in lifetime experiences from
3.3% to 16.8%. Theses changes are found in both sexes; in men from 9.4% to 25.9 % and in women from 0.4 % to 12.5 % respectively. Moreover, the prevalenceof currently use any tobacco products other than cigarettes increases from 0.3 % to 2.3%. The percents changes are found in men from 0.8 to 2.8 and in womenfrom none to 2.1%. Students reported they exposed to SHS at home changes from 27.4 % to 32.4 %, while their exposure to SHS in public places decreases from62.5 % to 49.8 %. Respondents reported their schools have official policy banning smoking in college buildings and clinics increase from 44.8 % to 68 % but thepolicy enforcement is slightly decreased from 88.9 % to 84.1%. Their perception of being role model for smoking cessation is nearly the same at 98 %, and theneed for cessation techniques increases from 80.9% to 91.9%. Percentages of dental students reporting that they have learned cessation approaches to use with
their patients increase from 14.1% to 32.7%. Some positive changes in dental students are more likely contributed by the activities of the Thai Dentist Against
Tobacco Network that try to incorporate the health impact of tobacco and smoking cessation lesson into the dental curriculum, and involve the first two years ofdental students in antismoking campaign since 2002.
The studies are supported by the Tobacco Control Research and Knowledge Management Center (TRC) Thailand.
Key words: Thailand GHPSS, Tobacco use, Dental student

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P-S10-44

Survey of Pharmacists about Tobacco

Takuya SHIDARA1, Tatsuhiro KOMOTO1, Yuji SAKURABA1, Emi KISARA2, Keiko KAWASHIMA1, Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2[Purpose]The smoking rate in Japan is 21.7% in fiscal year 2011 (according to JT) . The rate is higher than those of the other developed nations (20% or less).
Japan Pharmaceutical Association started the anti-smoking campaign in 2003, issuing 6 declarations, one of which reads "all the pharmacists should completely
quit smoking". I researched if the pharmacists really stopped smoking through questionnaire survey.
[Method]The time period for the questionnaire was from October 25, 2012 to November 30, 2012. The questionnaire on tobacco habits was conducted to thepersonnel working in ninety hospitals and twenty-four pharmacies in Hokkaido, Japan. The questionnaires were left with the respondents to be picked up at
a later date. The respondents answered the questionnaires unsigned. 110 men (37.8%) and 181 women (62.2%) answered to the questionnaires. Of the 291
respondents, 145 (49.8%) were hospital pharmacists, 93 (32.0%) were pharmacists working in community pharmacies, and 53 (18.2%) were clerks. The response
rate was 98.6%.
[Results and Consideration] The smoking rate of the pharmacists in Japan (Hokkaido) was 14.4% (13.8% for hospital pharmacists, 11.8% for pharmacists
working in community pharmacies, and 20.8% for clerks). Ex-smoker ratio was high with 17.5%, which suggests that, since the declaration in 2003, theawareness of the importance of no-smoking among medical professionals was raised. However, currently, the smoking rate for pharmacists is not zero. Looking
at age groups, pharmacists in their 20s were highest in both no-smoking rate (37.9%) and anti-smoking education rate(42.9%). In the United States, no-smoking
programs are carried out in schools in order to help young people refrain from smoking or quit. In Japan, pharmacists in their 20s, who were educated in school
not to smoke, were highest in no-smoking rate, which suggests that anti-smoking education in Japanese schools contributed to the lowest rate of smoking forthe young Japanese pharmacists in their 20s. Henceforth, it will be one of the important tasks for pharmacists to visit kindergartens and elementary schools to
educate younger children about the health benefits of no-smoking life. In addition, Japanese pharmacists should keep up with the international movement toward
completely smoking-free society.

P-S10-45

Smoke Free Campus on Active Participation of Student Forum- SHUBASH at Southwestern Part of the Bangladesh

Md Aminul I. BAKUL, Ishrat C. ISHRAT, Abdur R. RAZZAKThe Union South East Asia
Background: AID has been implementing a project; strengthen implementation of the tobacco control law in Khulna Division particularly provisions of making
public places and transports since September 2009 to till. To implement the project AID realized that voluntarism of University Student made pivotal role
because student is the main targeted consumer of the tobacco company and in future student will be played major role for law compliances when they are atservices in different public places and Govt. offices as authority.
Challenges: Most of the student and university authority were not aware about tobacco control law. As per survey report, 40% University male and 10% female
students were the smoker and promotional activities prevailed by the tobacco industry, involved student to their Corporate Social Responsibility activities, lackedof compliance of the smoke free law at the university area. Political instability of the university campus and vacation, examinations reduce the presence of thestudents.
Intervention: One to one advocacy with students; teachers and authority, law sharing meeting with students and teacher, mass awareness on performed culturalshow, student committee formation and quarterly meeting, world no tobacco day observation, sticker campaign, training on harmfulness-tactics of tobacco
industry, advocacy with the university authority, formed anti tobacco student forum on other university colleges.
Results: Campaign among the 1,20,000 students and 6000 employees, 420 students transports and common students places of Islamic University, K.C. College
of Jhenaidah, M.M. University College, Jessore, Jessore Science and Technology University, Khulna University, Kushtia Govt. University College and Magura
University College declared as smoke-free , anti tobacco student forum formed in University, all kinds of direct and indirect advertisement banned in university,
student forum against tobacco formed at others university and colleges.
Conclusions: Need more student awareness and participation, indirect promotional activities should monitor by the university authority, measures against
tobacco industry's Corporate Social Responsibility at university.
This experience would be waved to other universities which would be led by others students.

P-S10-46

Prevalence and Determinant of Illicit Cigarette Consumption in East and Central Java Province, Indonesia1

Nur Hadi WIYONO1, Ayke Soraya KITING1, Elda L. PARDEDE1, Abdillah AHSAN1, JM. BOWLING2, K. FOONG3
University of Indonesia1, University of North Carolina2, University Sains Malaysia3
Background: There are two types of illicit trade cigarettes: smuggling and illicit domestic cigarettes. While smuggled cigarettes are a leading issue in othercountries, illicit domestic cigarettes are considered the major concern for Indonesia.
Objective: The objective of this study is to assess prevalence and determinants of illicit cigarette consumption in East and Central Java province, Indonesia.
Method: The survey was conducted on November, 2010 till January 2011. The total number of respondents in East and Central Java Province was 2,394. In
each selected province, male and female smokers aged 15 years and above was selected.
These respondents were selected using a Multistage Random Sampling method.
The interviewers collected empty pack from respondent to be identified by the researchers whether the pack was illicit or not.
Result: This study found that that there are 4.85 percent illicit cigarette was consumed by respondents in Central and East Java. Compared by region, illicit
cigarette consumed in Central Java was 2.3 percent and in East Java was 7.2 percent.
Those that smoke illicit cigarette are found more in East Java, older generation (65 year or above), live in rural area, have low education (below elementary), andlow income. The illicit cigarette price is very cheap that is Rp1,500 – Rp 3,000 (US$ 0.17-US$ 0.33) per pack.
Conclusion: The illicit cigarette was mostly consumed by low income and low educated people. The existence of illicit cigarette that especially produced bysmall scale industries has provided more choice for the smokers so that they are easily to switch to illicit cigarette if the legal cigarette price hikes.
This project received support from the NIH Fogarty International Center (Grant Number R01TW007924), awarded to Duke University's Program on Global
Health and Technology Access in collaboration with the Southeast Asian Tobacco Control Alliance and the American Cancer Society. The content is solely the
responsibility of the authors and does not necessarily represent the official views of the Fogarty International Center or the National Institutes of Health.

1

183

P-S10-47

Exposure to Secondhand Smoke and Its Relationship with Academic Performances and Cognitive Abilities amongPrimary School Children in Serdang

Emilia ZAINAL ABIDIN, KHAIRUNISA SALIMAN
Universiti Putra Malaysia
Introduction: Majority of children are involuntarily exposed to tobacco smoke mainly by adults, in the places where children live, work and play. There has
been evidence of a relationship between poor cognitive performances and Secondhand Smoke (SHS) exposure among exposed children. Exposure to SHS has
often been objectively measured via biomarkers such as salivary cotinine. Objective: This cross-sectional study was conducted at one of the primary school in
Serdang, Malaysia. The overall aim of this study was to determine the association between exposure to SHS with academic and cognitive performance among
primary school children. Methodology: All of the students in year 5 of primary school in Serdang were invited to take part in this study by distributed the consent
form. 68 of the students agreed to participate from 127. Parental-administered questionnaire was used to obtain background information and smoking exposure
estimations. Saliva collected from children was used to determine the levels of cotinine measured via Salimetrics Cotinine ELISA kit. Latest examination resultsof the participating children was obtained from the school, while cognitive ability was measured using Wechsler Nonverbal Scale of Ability (WNV) test. Ethicalapproval was obtained from the Universiti Putra Malaysia Ethics Review Board. Results: This study found that 39.7% of respondents lived with a father thatsmoke and 27.7% of them had a salivary cotinine level exceeding 0.1 ng/ml. There was a significant association between children’s SHS daily exposure andsalivary cotinine concentration (p<0.05). No significant relationship was found between SHS exposure and academic performance and cognitive ability (p>0.05),
however, there were clear patterns of higher SHS exposure and poorer academic performance and cognitive ability. Conclusion: This study was preliminary
study which contributed a baseline data on exposure to SHS and academic performance as well as cognitive ability among schoolchildren in Malaysia. There wasno association between SHS exposure and academic performance and cognitive ability. This study suggests a further research on exposure to SHS and academic
performance using retrospective study design.
Keywords: Secondhand Smoke, Salivary cotinine, Enzyme- Immunoassay, Schoolchildren, Parental-reported, Cognitive, Academic performance

P-S10-48

Quit and Win 2012

Kong MOM , Yibee HUANG2
Cambodia Movement for Health1, Taiwan International Medical Alliance2
1

Quit and Win is one of few smoking cessation programs run in Cambodia. It was the third time that the Quit and Win Campaign 2012 was carried out in the
country with financial support from Taiwan Bureau of Health Promotion.
1,288 pairs, smokers and non-smokers as supporters, registered in the campaign, almost 20% increased compared to the Quit and Win 2010. Almost half of themwere farmers, followed by small/household business dealers (taxi drivers, mechanics), laborers, office workers, armed forces, teachers, students, retired-persons,and Buddhist monks. 3% of them were women and 2% was under 18 years old.
Half of them were long term smokers who smoked more than 10 years, while one quarter smoked between 5-10 years and another quarter smoked less than five
years. More than 75% of them were heavy smokers by smoked more than 10 tobacco sticks per day and smoked the first cigarette within 30 minutes after waking
up in the morning.
Half of them learned the campaign by radio and television advertisement, followed by posters, leaflets and advertising on three wheel vehicles.
Because most people who registered were from rural areas where internet access was very limited, more than 99% of them registered through phone calls.
National ID number for both smokers and supporters were required when registering.
Smokers who registered in the campaign were well informed to abstinence from smoking for one month period.
5% of the registered was randomly selected through computer lottery program for one month follow up interviews through phone-calls, and 64% was the successrate.
The selected candidates were interviewed and tested CO before entitling the winners. The winners were awarded motorcycle, television and hand-phones.
The Quit and Win Campaign did not only alert public about the danger of smoking and help smokers to quit, but it also contributed to the implementation of the
FCTC’s Article 12 and 14.

P-S10-49

Perception of Second Hand Smoker and Support Toward Smoke Free Area Among Public in Kota Bharu, Kelantan

Harmy MOHAMED YOSOFF1, Aisyah Aliana MOHD ZABIT2, Siti Syafiqah SUHAIMI2, Nurul MOHAMED2
School of Medical1 Sciences, Malaysia2
Introduction: Second Hand Smoke (SHS) kills more than 600,000 people worldwide every year. It has been known to aggravate asthma in childhood, increaserisk of lung cancer, lung infections and cardiovascular disease. Creating Smoke Free City was found to be an effective strategies to reduce tobacco related
morbidity.
Objectives: The purpose of this study is to determine the perception of public on Second Hand Smoke and it’s ill effect and their support toward smoke freearea in Kota Bharu, Kelantan, Malaysia.
Method: The survey was conducted in 8 most visited location in Kota Bharu city centre including bus stations, shopping complexes, wet markets and recreational
area. People aged 14 and above were given self administered questionnaire.
Results: Four hundred and sixty five respondents were enrolled and majority of them were muslim (99.8%). About 64 % of them were female. About 29.2 % ofthem were expose to SHS. Most of them know the danger of SHS toward health. Public place (91.6 %), Restaurant (87.4%), public transport (67.1%) and theirown house (62.7 %) were the places where they commonly expose to cigarette smoke. More than 90 % of them support the legislation to protect non smoker.
Majority of them (more than 90 %) support toward smoke free area including workplace, restaurant, cinema and other public area.
Conclusion: Majority of public in Kota Bharu City centre are aware about the danger of SHS and most of them support any measures to protect non smoker
including legislation and creating smoke free area.

184

2-School of Population Health, University of Queensland, Australia
Background: Modelling is increasingly being used to guide decision-making aroundachieving long-term tobacco control goals and also for comparing the likely costeffectiveness of specific tobacco control interventions.

P-S10-51

Methods: We adapted a dynamic forecasting tobacco model for Australia (Gartner et al.,2009) to the New Zealand (NZ) setting using detailed census and health survey data
including the most recent 2011/2012 health survey. Model enhancements included:
What is Needed to Achieve New Zealand’s Smokefree Nation
Goal: Resultsfrom a ForecastingModelconsiderationof ethnic heterogeneity;
and NZ-specificrelative risks (from the NZ Census
Mortality Study).

Takayoshi IKEDA1, Linda COBIAC1,2, Nhung NGHIEM1, Kristie CARTER1, Nick WILSON1, Tony BLAKELY1
Results: The baseline model fit with the census and survey data was evaluated. Results
University of Otago1, University of Queensland2
feed into the forecast model which will project smoking prevalence out to the year 2025

and beyond. Key parameters calculated are for smoking initiation and long-term cessation

35
30
25
0

5

10

15

20

25
20
15
10
0

5

Prevalence (%)

30

35Modelling is increasingly being used to guide decision-making around achievingwith
long-term
tobaccocontrolgoals and also
for comparing
the likely
uncertainty
estimates.
A business-as-usual
scenariowith current trends
resultedcost
in aeffectiveness of specific tobacco control interventions.
smoking prevalence of 9.5% (95% CI 7.8-11.9%) in Non-Māori and 19.1% (11.3-15.9%) in
by 2025.
halving (NZ)
initiation
rates every
andcensus
doublingand
the healthcessationrate
We adapted a dynamic forecasting tobacco model for Australia (Gartner et al., 2009)Māori
to theNew ByZealandsettingusingdecadedetailedsurvey(“Scenario 2”),prevalence
dropped to 5.7and
andNZ-specific11.3%, however
by 2028risksand 2038
theydata including the most recent health survey. Model enhancements included: considerationof ethnic
heterogeneity;
relative(from
NZ
dropped below 5%, respectively. To achieve the prevalence goal of 5% by 2025, theCensus Mortality Study).
model suggested adopting more augmented scenarios, in which cessation rates were
The baseline model was evaluated and results feed into the forecast model whichincreased
projectsthreefoldsmoking
tofivefold
2060.forKeyparameters
calculated
areareforfor prevalence
Non-Māori and
Māori(“Scenario 3”).
The resultssmoking initiation and long-term cessation with uncertainty estimates. A business- fairly compatible with similar work from Australia, Finland and one former NZ study.
as-usual scenario with current trends resulted in a smoking prevalence of 11%
Non-Maori
Maori
and 9% for non-Māori males and females, and 30% and 37% for by 2025. By
halving initiation rates every decade and lowering cessation rates to 10% and 20%,
Business-as-usual
Business-as-usual
Scenario 2
Scenario 2
prevalence dropped under 5% for non-Maori and Maori by 2025, respectively.
Scenario 3
Scenario 3
The results are fairly compatible with similar work from Australia, Finland and2025
one former NZ study.
Reaching NZ’s 2025 smokefree goal does not appear likely based on current trends
2025
and hence new interventions would need to be introduced to achieve it for NonMaori and Maori populations. Policy makers will need to: (i) further enhance useof established interventions (eg, tax); and/or (ii) adopt new overarching tobacco
control strategies (eg, supply controls). This model can also be adapted to study
the cost-effectiveness of these established and new tobacco control interventions.
2020
2040
2060
2080
2100
2020
2040
2060
2080
2100
Year

Year

Conclusions: Reaching NZ’s 2025 smokefree goal does not appear likely based on
current trends and hence new interventions would need to be introduced to achieve
P-S10-52 Tobacco Control Basic Training in Taiwan-the Health CareprevalenceProfessionals
Attitudes
andof 5% for Trainees’s
Non-Māori andKnowledge,
Māori populations.
Policy makers
willBarriers
either need to:(i) further enhance use of established interventions (eg, tax); or (ii) adopt new overarching
tobacco control strategies (eg, supply controls). This model can also be adapted to study
Pei Wen TIEN
the cost-effectiveness of these established and new tobacco control interventions.

Taiwan Nurses Association

Smoking has been known as an important factor which impacts on people’s health in Taiwan, including cancer, lung disease, and cardiovascular disease. Healthcare professionals such as nurses, social workers, and psychologists, etc. are in an excellent situation to deal with smoking cessation and could be competent topromote smoking cessation. Therefore, Taiwan Nurses Association provided the tobacco control education training in 2010.The basic training aims to reinforce
the TC education that college education lacked. Another main purpose of this training project is to focus on the concepts “2A +R (Ask, Advice, Refer) much morepractical in daily life. In 2010, There were 759 people participated the basic education training, 752 trainees joined the posttest, 681 of them passed the test; thetrainees including nurses, social workers and psychologists, etc. We used cross-sectional survey deign and the modified questionnaires (a)“Oncology Nurses andTobacco Control ” Chinese version(originally developed by Dr. Sarna) (b)”Tobacco Control Policies Questionnaire ”(developed by Dr.Lai) to survey the healthcare professionals trainees (N=686 from original 759 subjects, response rate: 90.38%).
Results：
Knowledge: Correct rate of the pre-test and the post-test:。Those who participated the test made progress in tobacco control knowledge.
Attitude:Majority of health care professionals do not smoke and have very positive attitude toward tobacco control. 90.4% of them agree with that health care
professionals should be a good model, and 58.5% of them considered that provide the information of damaged causes by tobacco is important. Yet, these heathcare professionals are lack of TC activities applied.
Barriers of helping patients to stop using tobacco-- from trainees’s perspective:
Most of basic trainees perceived many barriers to involve tobacco control and smoking cessation. Patients are not motivated/interested to smoking cessation
ranked as first barrier. Lack of skill comes in second barrier. Lack of knowledge, time and confidence are important barriers factor as well.
Conclusion and Suggestions:
1. Need for tobacco control education programs (school and in-side training). 2. Suggest to make 2A+R method outreach to clinical and community.

P-S10-53

Quit & Win Campaign 2012 Promotional Strategy—Social Smoking Cessation Carnival Atmosphere Encouraged Over30,000 Participants to Quit Smoking

Shu-Li CHEN, Ching-Li LIN, Ying-Chun CHEN, Tzu-I LU, Jen-Huan HUJohn Tung Foundation
Taiwan has launched the International Quit & Win campaign since 2002, and continues to do so every other year. The campaign has successfully aroused theparticipation of government, enterprises, hospitals, schools, media, NGOs and countless individuals. In 2012, with 31,067 groups of participants registered in the
6th campaign, this biannual smoking cessation event broke the record on the number of participants.
With a variety of promotional strategies, Quit & Win 2012 invited celebrities to be involved in the Campaign as volunteers and spokespersons. Ms. Ariel Lin（林依晨）, the winner of the 43rd Golden Bell Award in the Best Leading Actress, volunteered to be the spokesperson of the campaign, with her fellow young star
Mr. David Hsu（許豪恩）. During the registration period, John Tung Foundation (hereinafter referred to as JTF) organized promoting activities, press releases,
often with celebrity involvement. The TV stations, radio stations, newspapers, and magazines all helped putting on the promoting materials for Quit and Win
free of charge. JTF also cooperated with governmental health authority and medical facilities to distribute the registration forms and the promotional materials.
The cooperation with the Ministry of Justice also attracted the inmates, which is a large group with high smoking rates, to register the Quit & Win campaign andtry to cease smoking.
JTF had conducted telephone interviews after registrations were filed, to check if personal information is correct, verify the qualification, encourage participants
to quit smoking, offer them correct smoking cessation concepts, and refer them to smoking cessation services if so desired. After confirming the information, theregistrants were considered eligible for later drawing of the prizes if they could successfully refrained from smoking during the campaign period.
Also, all the prize winners and their families would celebrate the moment at a press conference, together with the participation of supporting government officials
and celebrities. All in all, in Taiwan, Quit & Win has been a cheerful and interesting smoking cessation campaign for the public in general. However, due tothe lack of resources, the 2012 Quit & Win might become the first time that JTF will not be able to continue tracking the participants and thereby conduct theafterwards survey and analysis.

185

P-S10-54

Using Intervention Mapping to Describe the Development of the Malaysian Advisor’s Smoking Cessation Website

Omar S. ATTIYAH, Faizah SAFINA
Universiti Malaya
Previously, we had conducted an evaluation study for the Advisor’s website for Smoking Cessation Program among pharmacists who did not have any priorexperience of the smoking cessation program. However, there is insufficient description about the Advisor’s website. Hence, the aim of this paper is to describe
the design and the development of the Advisor’s website for Smoking Cessation Program using the Intervention Mapping protocol. The website is delivered
through the World Wide Web “Internet” and it incorporates multiple levels with supportive element named “Helpline”. It is applying the buddy system to makeuse of the advantages of social support on increasing the motivation and commitment to quit provided by smoker’s family members, friends or peers. The
theoretical foundation for the program based on the self-regulation theories, trans-theoretical model, cognitive behavioral therapy, coping skills training andmotivational interviewing. The different sessions in the program are arranged according to relapse sensitive scheduling and stages of change of trans-theoreticalmodel. The behavior change is brought gradually and in case of slips or relapse there will be a recycling back before progressing again. Coping skills are also
included in the website to provide the quitters with wide range of relapse causal elements like cravings, emotional (depression, stress) and situational factors(drinking coffee or alcohol, hanging out with smokers). Both behavioral and cognitive coping strategies are applied for the coping skills. The Advisor’s website
for Smoking Cessation program provides the stepwise guidelines for counselors and healthcare providers to lead the smokers during his quit attempt and help
the quitters to maintain abstinence as long as possible. Furthermore, the dynamic features of the website enable data entry and retrieval. Intervention mapping
protocol is used in describing the program since behavior change interventions still represent mysterious objects to most healthcare providers and academics
so intervention mapping used to simplify these interventions and help in providing a full description of the development of both these interventions and theirbuilding blocks.

P-S10-55

Present Status and Problems of Non Smoking Activities in Rural Areas--- Through the Activities of the Board of Studies Smoking Yamagata

Shuichi OTAKE
Yamagata Smokefree NPO corporation
Through the activities of promoting non smoking so far in Yamagata Prefecture, consider the issues and problems.
Yamagata Smokefree NPO corporation began working as a principal medical personnel since 2000. I have in mind thecharacteristics of the activities of Yamagata
1)Gather local resources: NPO was supported by the Prefecture Medical Association, Dental Association, the Board of
Pharmacists, and Nurses Association, the school activities, local government, health center, board of education, business,
education committee. NPO has gained financial support from organizations and local government grants to NPO.
2)Human resources in the region excavation: We conduct regular training sessions twice a year. In order to increase thephysician of smokefree outpatient, we supported the meeting of medical study group. Such as budget of ¥ 400 000 per year,
health care organizations are engaged in publicity events on a regular basis.We are doing a workshop continued to recruit
volunteers for general Smoking prevention education. Young pharmacists have become the center of Smoking prevention
education.
3)Information dissemination in the country: Smoking prevention education audience has come to 70 000 people. I've been
doing a brochure issued by sharing and teaching material slides, digital materials. Materials have been widely deployed in
the Internet.

< Smoking prevention education pamphlet created by the
NPO> prevention education pamphlet created by th< SmokingNow, our problem is Powerful block of tobacco businesses, the thinness of involvement in politics.
Now,
ourbecomeproblemis Powerfulof tobacco businessHow do I prevent the interference of the tobacco industry, hasa bigchallenge.block
Increase
the appeal to politicians, I want to continue to increase instrictpublicHow
opinionpolitics.
do Iagainst
preventsmoking.
the interference of the tob
NPO member is constantly changing. Continue ongoing activities, to increase the young
membership, efficient operation has become an issue. challenge. Increase the appeal to politicians, I want to copinion against smoking.

P-S10-56

How to Make the Masses do Effective Tobacco-free Actions

Takahiro SUZUKI , Atsuko KAWAI
Office worker1, Kotokukai Total Health Clinic2
1

2

NPO member is constantly changing. Continue ongoingmembership, efficient operation has become an issue.

Today, not only medical professionals, but also masses of non-professional people, who do not have much knowledge or special skills, try to make actions for
tobacco-free society. However, it is still difficult for them to make their ideal outcomes because most of them do not have enough fund and influential voices
to civil society. Therefore, we examined what kind of activities can make use of non-professional individuals’ advantages and are effective to facilitate theiractivities.
As a result, we found that activities toward to group or organizations, such as action to a local-government or public institutions, reforming administration’s wayof thinking based on passive smoking trials, and strengthen protection for children against passive smoking. On the other hand, activities toward individuals, suchas enlightenment individuals, consulting for quitting smoking, and forming parties, are seemed difficult to make positive outputs.
From these results, it becomes clear that even laymen can make good performances if the activities match with their abilities and skills. Then, when they cancooperate with medical professionals, it will be able to make up for each other’s weaknesses, and it leads the groups become bigger. Bigger parties make ideal
tobacco-free society come true. Therefore, medical professionals, who work and organize associations toward tobacco-free, should offer more opportunities andmake frank and comfortable environment for those who does not have enough skills and knowledge.

186

P-S10-57

Tobacco Free * Japan TV - an Innovative Platform to Drive Tobacco Free Policies in Japan

Yumiko MOCHIZUKI
National Cancer Center
Background and Purposes: Since FCTC, there arose a dozens of national and local NGO activities on tobacco control which are a major driving force to curb
the epidemic in Japan. But at the same time, due to lack of a shared platform in the society to concentrate their whole energies to win the game, tobacco industry
is still swimming freely in Japan to manipulate the social norm and to penetrate into the policy making process with massive efforts through the media. We
produced “Tobacco Free * Japan TV” as an innovative platform to function as a KNOT between global movements and local movements to link various tobacco
control communities and individuals with visualize their relationships using TV-type of programs to join and facilitate the communication by SNS.
Methods: We produced the Tobacco Free Women TV (TFWTV) project (http://www.ustream.tv/channel/tobaccofreewomentv) as a prototype of Tobacco Free
* Japan from March 2012 to February 2013 to stimulate the local initiatives with provision of different types of program contents inviting various experts andrepresentatives from different organizations. Using this experience and social reactions, we upgraded this project to Tobacco Free * Japan TV (www.tobaccofree.
jp) in order to facilitate the mutual communication among advocacy groups and to strengthen their advocacy power linking with their local movements to global
movements.
Results: As of February 13, TFWTV produced more than 70 various live shows and gained about 10,000 total views and 2400 unique viewers to watch ourshows. In order to introduce the local activities, we developed more than 20 message videos of individuals from each area and 5 promotional video messages ofeach organisations. To facilitate the local live station, we conducted two workshops how to launch a local channel. As a result, more than three local organization
became interested in running their own programs. Introducing this approach, we empowered the conventional symposium or annual meetings of existingorganizations (Japan Cancer Association, UICC Japan Committee, Japan Medical Dental Association against Tobacco) to maximize their dissemination powerwith interactive ways. Marking FCTC Day (February 27), we will grade up TFWTV to Tobacco Free * Japan TV to gather key NGO organizations by providing
the shared platform and integrating the common vision in order to make Tobacco Free Japan for our future generation.

P-S10-58

Effects of a Cigarette Smoking Prevention Program among Junior High School Pupils in North-East Thailand: A Pilot Survey

Anun CHAIKOOLVATANA B.1, Mereerat MANWONG1, Niyom JUNNUAL1, Cholada CHAIKOOLVATANA2, Wantanee THONGNUN3,
Jamsai APIRAKMONTREE4, Areepan WANCHAI5, Maleewan PONGPAEW5
Ubon Ratchathani University1, University of Phayao2, Sapasithiprasong Hospital3, Pratumpithayakom School4, Sripratumpithayakarn School5
Objective: The study aimed to evaluate the implementation of a smoking prevention program via a questionnaire paper. Both knowledge and attitudes towardsmoking behavior and smoking cessation were also investigated.
Materials and Methods: An experimental study was conducted from October 2011 to July 2012. Two hundred and twenty-six school students from Mathayom 1
to 6 participated into the study and they were divided into either a study group (n99) or a control group (n127). Participants in the study group underwent 2 daysof a smoking prevention program and the control group was not subjected to this program. Both groups completed a questionnaire containing questions related to
the knowledge of the dangers of cigarette, attitudes toward smoking behavior, and smoking cessation at 3 different stages, pre-program, immediate post-program,and one month post-program. All data was analyzed via statistical methods.
Results: Participants in study group were smokers and non-smokers, aged between 13 and 15, studied in Mathayom 1 to 6. It was reported that 75 percent ofsmokers had tried to quit smoking at least once but the majority had failed. For those who quit smoking successfully, 83.6% sought advice from their families.
Regarding knowledge related to the dangers of cigarettes, the study group had significantly higher scores than the control group at the three different stages(pre-program, immediate post-program, and one month post-program p=0.001, 0.001, and 0.024 respectively). The attitudes toward smoking cessation behavior
between the groups were significantly different at the three different stages (p=0.03, 0.01. and 0.001 respectively). The influential factor significantly related todecision-making related to quitting cigarettes was advice, especially from friends and families (p<0.05).
Conclusion: School students aged between 13 to 15 years of age studying in Mathayom 3 (grade 9) represented the majority of smokers. The study found thesmoking cessation prevention program was able to improve knowledge of the dangers of cigarettes. After the completion of the program, the effect of factors on
their lives such as medical conditions, social norms, and friends and families made smokers realize the importance of quitting smoking.
Keywords: Cigarette smoking prevention program; Smoking cessation behavior; Smoking cessation
Correspondence to: Chaikoolvatana A, Department of Pharmaceutical Science, Ubon Ratchathani University, Thailand. Phone 045-353630, Fax 045-353626
E-mail: kkjc5476@yahoo.com

P-S10-59

School Tour for “Smoke Free Homes Campaign” Project

Chawala PAWAPUTANONT1, Sangduean SUWANRATSAMEE2
Action on smoking and Health foundation1, ThaiHealth Promotion Foundation2
The 2011 Thailand Global Adult Tobacco Survey (GATS) shows that 36 % of Thais, 15 years and above, are exposed to second-hand smoke in their homes. To
address this problem, ASH Thailand launched a campaign to urge Thai smokers not to smoke in their homes. The project is titled, “School Tour for Smoke Free
Homes Campaign.”
Objective:- To involve kids aged 3-9 years old to ask their parents to quit smoking.
- To involve parents to be non – smoking role models.
- To campaign for smoke-free homes through school activities
Method:Ten schools were enlisted to join the project with a target of including 200 students and 100 parents from each school. Students are involved in campaign
activities such as puppet story telling; demonstrations on how cigarette smoke reaches the lungs; the bad smell of second - hand smoke, parents’ modeling gameand a bingo game, and a student and parent contest to design smoke - free home signage.
Evaluation:
Students are included to discover what they have learned, which activities they like the most; how they told smokers not to smoke in the home, and how they told
smokers they encountered that smoking is not good for anyone’s health.

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Tobacco Control Advocacy with the Indian Film Fraternity

Blesson THOMAS, Tshering BHUTIA, Devika CHADHA
Salaam Bombay Foundation
Context: Tobacco consumption among children is a growing problem, with many young lives lost as a result of oral cancer caused by use of tobacco, whichis completely preventable. In India, movie stars often enjoy a demi-god status, and expectedly whatever they portray has a profound influence on the thoughts
and actions, especially those of the youth. The Ministry of Health and Family Welfare notified the rules for Cigarettes and other Tobacco Products (Prohibitionof Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) [second amendment rules] 2011, to be implemented from 14th
November, 2011. The rules were notified after consultation and taking into account the views of Ministry of Information and Broadcasting to make it morepractical and implementable; however, it was met with a lot of criticism from the film industry including noted film-makers.
Methods: In 2011, two sensitization workshops and a number of one to one meetings were conducted by Salaam Bombay Foundation with regional officers andother key members of the Central Bureau of Film Certification (CBFC). The World Health Organization and the Ministry of Health and Family Welfare werealso a part of the advocacy campaign.
Results: The Ministry of Information and Broadcasting in August 2012, issued a notification to the CBFC requesting it to ensure that a static anti-smoking
message be displayed for the duration of the smoking scene in the film, and a 20 second anti-smoking message as approved by Ministry of Health with voiceoverof one of the actors who is seen smoking in the film to be displayed at the beginning and in middle (after interval) of the film. This notification has also been
displayed on the website of the CBFC.
Conclusion: Although it was difficult to get the support of the film-makers for anti-smoking messages in Indian films, the advocacy efforts of Salaam Bombay
Foundation involving the Ministry of Information and Broadcasting has added to the efforts of the tobacco control advocates in implementing anti-smoking
messages in Indian films.

P-S10-61

SMART Journal for Tobacco Control Project

Suksan SELANON
Action on Smorking and Health Foundation
Since 1999, Action on Smoking or Health (ASH) Thailand has produced the monthly SMART journal.The SMART journal reports current tobacco control
related information, provides analysis of hot issues, promotes new ideas, and tobacco control campaign ideas. Every month, 10,000 copies of the journal are
distributed free of charge to to all target groups including the media, public health professionals, government officers as well as students and teachers in education
institutions.
Concept
1. Disseminate and propagate tobacco control news, current events and activities to the media, our partner, the general public and networks in the country andneighboring countries of Cambodia, Laos and, Vietnam
2. Disclose the tobacco industry tactics and denormalize tobacco industry
3. Publicize the tobacco control program activities of the Action on Smoking and Health Foundation (ASH Thailand) and partners
4. Serves as a resource and support in helping our networks to plan for effective tobacco control campaign
5. Serve as tools among the tobacco control advocates in sharing and exchanging information and experiences
Impacts
1. The SMART members and networks get regular innovative ideas to develop tobacco control campaign strategies continually
2. The SMART journal becomes a platform for, tobacco control community in Thailand to exchange ideas. and experiences.
3. Information is regularly synthesized and used in other local magazines, newspapers, radio and even as part of school lessons
4. Expanding national networks and campaigns through Smart Journal
5. It becomes a gateway for dissemination of tobacco control information from around the world

P-S10-62

Survey of Care Workers about Tobacco

Yuji SAKURABA1, Tatsuhiro KOMOTO1, Takuya SHIDARA1, Emi KISARA2, Keiko KAWASHIMA1, Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2[Purpose] In "Kenko Nihon 21 (Healthy Japan 21)", a project by Ministry of Health, Labour and Welfare to encourage Japanese nation to be healthier in 21st
century, it is written that "healthcare providers should try to quit smoking on their own". Both Nihon Ishi Kai (Japan Medical Association) and Nihon YakuzaishiKai (Japan Pharmaceutical Association) issued a declaration of no-smoking for doctors and pharmacists, and have been active in their anti-smoking campaigns.
In order to research on smoking habits of other healthcare providers, especially care workers, a questionnaire survey was done to care workers and clerical staff.
[Method] The time period for the questionnaire was from October 25, 2012 to November 30, 2012. The questionnaire on tobacco habits was conducted to thepersonnel working in ten nursing homes in Hokkaido, Japan. The questionnaires were left with the respondents to be picked up at a later date. The respondents
answered the questionnaires unsigned. 48 men (35.9%) and 89 women (65.0%) answered to the questionnaires. Of the 137 respondents, 119 (86.9%) were care
workers, and 18 (13.1%) were clerks. The response rate was 72.1%.
[Results and Consideration] The smoking rate for healthcare providers working in nursing homes in Hokkaido, Japan was 41.6% (42.0% for care workers and38.9% for clerks). The rate was much higher than that for doctors, which was 9.0% in 2011, according to Care Net, ltd.. In addition, 67.9% of care workers
had never been received anti-smoking education, which means that efforts toward no-smoking for care workers have been insufficient. Henceforth, doctors,
pharmacists and pharmaceutical companies all should work together to actively educate care workers about health hazards caused by tobacco and raise theirawareness against smoking. By continuously monitoring the smoking habits of healthcare providers, no-smoking education for them will be promoted and theirawareness will be raised.

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Adolescent’s Knowledge and Opinion on Cigarette Smoking : Findings from - ITC – SEA (Thailand) Survey

Tawima SIRIRASSAMEE1, Buppha SIRIRASSAMEE2, Aree JAMPAKLAY2, Ron BORLAND3, Geoffrey T. FONG4, David HAMMOND4
Srinakharinwirot University1, Institute for Population and Social Research2, The Cancer Council Victoria3, University of Waterloo4
Objective : To determine the knowledge and opinion on cigarette smoking among Thai adolescents.
Methods : A cross sectional, population-based, national survey was conducted among 958 Thai adolescents aged 13-21 years old, in 2011. Participants wererecruited using stratified multistage sampling from 5 regions of Thailand. Participants were asked to complete self-administered questionnaires. Data wereanalyzed using descriptive statistics and Chi-Square tests.
Results : More than 90% of participants know that smoking cause lung cancer in non-smoker, chronic obstructive pulmonary disease, mouth cancer andpremature aging. Approximately 70% of participants know that smoking cause stroke, heart failure and impotence. Only half of participants know that smoking
cause gangrene. There was no significant difference between knowledge about harmful of smoking on health between adolescent smokers and non-smokers.
Almost half of participants agreed that smoking is disgusting. However, 35% of participants thought that smoking makes young people look more mature and21% reported that most of the popular people their age smoke. Approximately 5% of participants agreed that smoking is a sign of being modern and helps tocontrol weight. For Thai adolescents, it is more acceptable for young men to smoke compared to young female. Overall, adolescent smokers have a better attitude
about smoking than non-smokers.
Conclusions : Anti-smoking campaigns are strongly recommended to create negative attitude on smoking especially among young adolescent to prevent themfrom smoking

P-S10-64

Survey of Knowledge and Attitudes toward Cigarette Consumption among Young Primary School Pupils, Ubon
Ratchathani

Niyom JUNNUAL1, Anun CHAIKOOLVATANA2, Soontorn SERASART2, Preeyaporn PHARUENG2
College of Medicine and Public Health1, Faculty of Phamacy2
BACKGROUND
Smoking at early age is more likely to greater dependency and result in greater difficulty to quit as an adult. The National Statistical Office of Thailand reported
an average age of smoker is between 15 and 18, however, there is no current data regarding to Thai smokers and also to student in primary school level (underage of 13), which is more increasingly concerned to the nation. Without data representing the current situation of cigarette smoking among school pupils, it isfearful that Thailand may face up a rise of new early-aged smokers and other problems including, health, social-environment, and crimes in the future.
METHODS
The study was a quasi-experimental, controlled group, pre/post-test design was included in this study. Totally, 155 participants were included into study, of which
65 are studies group and other 90 are control group. All participants filled out a questionnaire paper prior to a study (pre-test). Only study group underwent
tobacco control campaign activities for 30 minutes. Then, both groups filled out a questionnaire paper again (post-test). All data were evaluated via descriptive
and analytical statistics.
RESULTS
Mean knowledge scores of pre-test is significantly higher than post-test scores in study group (p<0.001). When compared between study and control group, it
was revealed posttest score of study group is significantly higher than control group (p=0.011). Nevertheless, mean scores of attitude between study and control
group are not significantly different (p=0.081). Noticeably, there are nine school pupils currently smoke. They also indicated their fathers are currently smoking.
The most important factors influencing to smoke included, friends, parents, and self-image with percentage of 28.57%, 28.57%, and 21.42%, respectively)
CONCLUSION
Young school participants had good knowledge and attitudes toward tobacco consumption. Nevertheless, some influencing factors to cigarette smoking such as
parents, friends needs to be minimized. Further investigations of the current situation of tobacco consumption among school pupils, good prevention education,and smoking cessation programs are advisedly recommended to prevent young pupils from cigarettes.

P-S10-65

Psychological and Social Determinant of Smoker; Street Children at Depok City, Indonesia

Mochamad A. RUSLIALDI, Tania KHAERUNNISA
University of Indonesia
Indonesia is one of the highest prevalence of smoking country in the world (WHO, 2011). Indonesia is also the highest smoker population among South East
Asia’s country (ASEAN Tobacco Control Report, 2007). Teenager in Indonesia consists of 30% of the total population. Among the teenagers in Indonesia, there
are groups of street children, most of them are uneducated and they do not have a family. Street children live in wandering life without any rules and limitations.
This condition increases their behavioural vulnerability especially their smoking behavior. It relates to the data from Community Service Research Unit of Jakarta
Institute of Statistics which shows that 69,15% street children have smoking habit as a dominant number from the others bad behaviors. It is very difficult forgovernment to give interventions. Until now there has been no research, programs and policies related to smoking behaviour of street children. In addition, street
children are also faced with various health risks and hazards such as drugs and HIV/AIDS which have high correlation with psychological and social factors.
Street children decide to buy cigarettes even though they are in low economical condition. Based on Philip Kotler theory shows that consumer buying behaviour
is influenced by cultural, social, personal, and psychological factors. Researchers want to see their smoking pattern habit and the reasons of their smoking
behaviour based on psychological and social determinant. This study is a qualitative study with in-depth interview method that combines with literature study.
This study is going to be conducted at Depok City – West Java District - Indonesia. Our respondents are street children who are included into teenager years (age
12 – 24 years old: WHO). From this research, researchers expect to find ways of intervention properly in reducing the rate of smoking behaviour among street
children by knowing their psychological and social reasons.
Keyword: smoking behaviour, street children, social, psychological
Conference Topic: N. Specific population (Child, AIDS, psychiatric patient, etc)
L. Education, communication, training and public awarenessContact detail: Mochamad Aldis Ruslialdi, Student of Department of Epidemiology Faculty of Public Health Universitas Indonesia, Indonesia.
Email address: asambutirat@gmail.com
Tania Khaerunnisa, Student of Nursing Faculty Universitas Indonesia, Indonesia. Email address: taniakhaerunni@gmail.com

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Awareness Survey of Individuals Who Actually Quit Smoking

Shigeto TAKAGI, Masataka SHOUDA
Semen's Insurance Health Care and Reserch Center
Purpose:To study methods of providing smoking cessation assistance to smokers, we surveyed individuals who actually quit smoking. Method: We surveyed
individuals visiting our Center between July 17, 2012 and December 11, 2012 for outpatient routine physical examinations, who had quit smoking within thepast year and were still not using tobacco. We asked them what prompted smoking cessation, and the method(s) used. Results: The 124 subjects (98 men and26 women) had a mean age of 47.2 years. Their Brinkman index until smoking cessation was 446.7 on average, and an average 5.5 months had elapsed sincesmoking cessation.Q1. Frequency of quitting smokingFirst attempt: 44%2nd or 3rd attempt: 37%4th or 5th attempt: 11%Q2. Triggers to quit smoking 1. Illness
or health deterioration: 28% 2. Consideration of future health: 16% 3. Cigarette price went up: 15%Q3. Method of quitting smoking1. Uneventfully, by
myself: 52% 2. With determination and patience: 27% 3. Visited a smoking cessation outpatient clinic: 15%Q4. Advantages of smoking cessation1. Saving
cigarette costs: 38% 2. Health has improved: 35% 3. Food tastes better: 35% 4. No longer looking for places to smoke: 24%Q5. Disadvantages of smoking
cessation 1. None: 50%2. Weight gain: 34%3. Difficulty communicating with other smokers: 10%Q6. Degree of confidence in being able to maintain smoking
cessation: 74%, on average Discussion: Many subjects cited personal health problems, such as illness, as triggers for quitting smoking. Over half of subjects
were able to stop smoking uneventfully on their own, indicating the importance of making smokers acknowledge the value of quitting smoking. To do this, sincesome subjects (though—only 10%) were directly prompted by recommendations received during routine physical examinations and health guidance, we felt
it necessary to recommend quitting smoking to all current smokers. Many smokers gave up smoking with determination and patience, such that we believed it
necessary to provide information on smoking cessation at outpatient clinics and OTC drugs to those with the desire and will to quit smoking. We also felt the needto continue approaching those who have quit smoking, not only by praising their efforts in achieving smoking cessation, but also by providing adequate advice
on post-smoking weight gain, as well as on nicotine withdrawal symptoms such as irritability, to assure the prevention of smoking relapse.

P-S10-67

Using Social Media to Monitor and Counter the Tobacco Industry (TI): The ASEAN Experience

Mary Jocelyn F. ALAMPAYSoutheast Asia Tobacco Control Alliance
OBJECTIVE: To share best practices from Southeast Asia on the use of social media to counter the TI
In recent years, social media tools and strategies for tobacco control advocacy have been emerging in the ASEAN. Whether for monitoring, surveillance, or
public advocacy, groups are harnessing the power and innovations of social networking platforms such as Facebook and Twitter to counter the well-oiled
campaigns of Big Tobacco.The Tobacco Industry itself recognizes the power of social media. Specifically, it is using the new media space to circumvent laws on
tobacco advertising and promotion.Tobacco control advocates, of course, have access to these same tools, platforms, and emerging best practices in social media.
In Southeast Asia, social media is used on two fronts: to monitor the activities and campaigns of TI, and then to more effectively counter the same. Worthhighlighting, for example: In the Philippines, civil society used Facebook, Twitter and Youtube to educate and enlist the public on tobacco industry interference,and in a months-long campaign to reform the country’s Sin Tax Law and ultimately raise the prices of tobacco products.
★In Thailand, TI’s CSR campaigns were exposed and countered using well-crafted videos that were posted on YouTube and made to go viral using Facebook.
★Facebook pages have been set up to specifically monitor and document TI campaigns that flout advertising and promotion bans throughout the ASEAN. Thesesame pages encourage the public to monitor and report examples of how new forms of marketing are being hatched by the industry.
★Tobacco control advocates in Malaysia and the Philippines used Twitter to direct-message policy makers and legislators.
★In Indonesia, Twitter and Facebook were used in a shame-campaign targeting western musical artists that accepted TI sponsorship of their concerts in Jakarta.
SEATCA has actively sought and encouraged best practices in using social media. Limited budgets for information, education, and media have long been a given
for civil society organizations. Social media allows collective nimbleness and magnifies the potentials of what limited resources advocacy groups have at theirdisposal. A discussion on the collected learnings and examples so far would greatly benefit any larger conversation on tobacco control.
Acknowledgements:
The SEATCA Regional Media Officers Network and the SEATCA Industry Surveillance focal persons provided inputs to this document.

P-S10-68

The Current State of Smoking Cessation Support Provided by Smoking Cessation Treatment Nursing Staff, Their Sense
of Humor and Communication Skills, and the Relevance of Humor and Communication in Job Satisfaction and SuccessNaoko YANO
Japanese Red Cross Medical Center
The current state of smoking cessation support provided by smoking cessation treatment nursing staff, their sense of humor and communication skills, and therelevance of humor and communication in job satisfaction and success in smoking cessation treatments.
Objectives: Fulltime nurses are necessary in smoking cessation treatments that are covered by insurance. However, at many treatment facilities, only doctors
are providing treatments, and the role of the nursing staff is not clear. Therefore, an investigation was conducted regarding the current state of care and support
provided by nursing staff in smoking cessation treatment programs, their humor and communication skills, and how humor and communication skills are related
to job satisfaction as well as the rate of success in cessation treatments.
Methods: Between April and May of 2012, 84 female nurses who work for Japan Society for Tobacco Control (JSTC) outpatient treatment programs weretargeted for a survey. The R 2.15.0 package was used to analyze the survey, and each scale was analyzed for correlation and multiple regression analysis. The
relevance of personal factors and scales were analyzed in the rate of success.
Results: An analysis of the correlation coefficient showed that humor was relevant with each scale. Multiple regression analysis showed that personal attributesof the nurses, such as their years of continuous employment, academic credentials, the lack of smokers in their family, and being able to work where they desired,were relevant to communication competency and also led to job satisfaction. Humor was relevant to communication competency, as well as dedication and job
satisfaction in cessation support. The option of making reservations for treatment appointments significantly increased the rate of cessation success.
Conclusion: Sense of humor is greatly relevant to communication and job satisfaction for nurses working in outpatient smoking cessation programs.
Key Words: smoking cessation , nurse communication Sense of humor

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A Team Approach for Raising the Quit Smoking Rate at a Primary Care Clinic in Japan

Masataka KATO, Akemi NOMURA, Yoko MIYAKE, Natsumi NAKAGAWA, Mai TANAKA
Kato Clinic“Every day is World No Tobacco Day!” is the motto of Kato Clinic. There are many flags with non-smoking signs on the wall and the song “Please quit
smoking･･･” is playing all the year round at the lobby.
The members of our staff are a medical doctor (president), 6 nurses and 4 medical clerks. (One doctor, three nurses and one medical clerk are smoking cessation
specialists certified by the Japan Society for Tobacco Control)
All staff including the medical clerks always ask about the clients’ smoking status and requests for smoking cessation therapy are dealt with appropriately,
dependant on their stage of behavioral change.
We hold information in common by reporting on smoking cessation support at the morning assembly and using clinical pathways.
We make an effort to become skilful at counseling to improve the quit smoking rate.
We try to prevent dropout by careful and respectful explanations including information about the potential adverse effects of smoking cessation drugs.
To maintain higher quit smoking rates we confirm a client’s non-smoking status by a phone call or E-mail every month after completion of smoking cessation
therapy.
As a result of these kinds of methods the quit smoking rate at the completion of smoking cessation therapy (3 months after starting to quit smoking) was around80%. The quit smoking rate one year after beginning to quit smoking was maintained at around 60%.
These kinds of methods make dropout patients retry to quit smoking. The number of retry patients is increasing gradually. The rate of motivations to retry to quit
smoking by supporting phone calls or E-mail was 62%.
The rate of quit smoking (one year after starting to quit smoking) for retry patients who dropped out by social habits (i.e. drinking) was 62%. They could copewith the drinking atmosphere this time. On the other side, drop-outs caused by so-called “stress” were 14%. They couldn’t correct their cognitive bias.
Nicotine dependency is a chronic disease that can easily relapse. So we intend to devote all our energies to stop relapse by our team approach.

P-S10-70

Stop Smoking through Fasting in Ramadan: The Unassisted Smoking Cessation Approach to Reducing Smoking Rates(The Case of Banda Aceh-Indonesia)

Rizanna ROSEMARY1, Fanny NAILUFAR2
Syiah Kuala University1, Universitas Serambi Mekkah2
Indonesia ranks as the third largest consumer of cigarettes in the world. More than 65 percent of the adult male population are active smokers. The Muslimmajority province of Aceh also has a high smoking prevalence among youth and adult males (Basic Health Research, 2010), placing Indonesia, particularly
Aceh at high risk for tobacco-related health issues. Poor tobacco regulation has been argued to contribute to the normalization of smoking behavior in Indonesia.
Assisted smoking cessation programs are likely to be ineffective due to the social acceptability of smoking as “normative behavior” (Nicther, 2006). Further,
the cost-effectiveness of assisted smoking cessation interventions is less relevant to low and middle income countries, such as Indonesia, where Nicotine
Replacement Therapy (NRT) is more expensive than the price of cigarettes (Chapman et al 2010: 5). Klingemann et al suggest that self-change is one way to cut
the line of tobacco addiction (2009: 1510-1511), and Islam, as the religious practice of the majority of the population in Indonesia, has a legal framework that puts
a high priority on self-change behavior, including with regards to health issues. One Islamic practice – fasting – is believed to act as a medium for self-change.
During the holy month of Ramadan, a high emphasis is placed on self-control, with Muslims expected to abstain from eating, drinking, and smoking, from dawn
to dusk. The International Quit Tobacco Project in Indonesia through its formative research has also identified a need to explore the issue of fasting in Ramadan
as a cultural setting for smokers in Indonesia to quit (Nichter 2006: 115). This paper argues that a smoking reduction approach through the fasting practice ofRamadan is highly applicable to Aceh, whose special autonomy status within the Republic of Indonesia allows for the implementation of Islamic Law (Syari’ah).
A preliminary study conducted in Banda Aceh examining 70 smokers’ efforts to quit during Ramadan revealed that 85 percent of smokers aged 15-20 consumed
less than one pack of cigarettes per day during the fasting month, compared to two to three packs outside of Ramadan. Most smokers who want to quit smoking
admit that fasting can help them to reduce cigarette consumption. It is argued that unassisted smoking cessation, in particular through fasting, can contribute tosmoking cessation efforts in Aceh Province. Therefore, the government of Aceh should develop an intensive anti-smoking campaign during Ramadan in order tohelp smokers to eventually quit their smoking behavior.

P-S10-71

Buddhist Monk Doctor Blows the Whistle on Marketing a "Cigarette-like Incense Stick” Which Violates FCTC
Art.16.1(c)Akinori KURUMA
Kouganji Temple, The Japan Society for Tobacco Control【Background】 Tobacco seems to be at least partly a “favorite” stuff rather than an addictive poison in Japan, since cigarette packages are often found as
offerings for deceased smokers at altars in Buddhist temples and at graves in cemeteries.
【Report】 In July 2010, a maker of Buddhist family altars and a candle company started manufacturing and selling a unique type of incense stick, called"Tobacco Incense Stick (TIS)". TIS were a newly marketed, thick and short cylindrical incense stick wrapped with white-bond paper, resulting in a strong
resemblance to a regular cigarette. 20 pieces of TISs were packed in a paper box mimicking a popular domestic cigarette brand "Seven Stars". The companies
claimed that 1) TIS is useful as a "cool" offering at altars or graves for memorial services to deceased smokers. 2) TIS makes it possible to express sympathy to
deceased smokers without causing any second-hand smoking. Furthermore it was found that the companies had applied for trademark rights for TIS, probably inconcert with a tobacco company. After purchasing and identifying the TISs, I emailed, faxed, sent certified mail to the companies and talked over the telephone
in protest against the marketing of TISs, because 1) tobacco is NOT an offering for deceased smokers but an addictive life-threatening poison. So TIS, mimicryof cigarettes, is not an offering either as it were "a Buddha's meal having devil's costume on”. And 2) TIS is violating the Framework Convention on Tobacco
Control (FCTC) Art.16.1.(c). A week later Executives of the companies notified that they had stopped producing TISs. The story was over without appealing to
the legal system.
【Discussion】 The above-mentioned story seems to be associated with a trend that smoking is still allowed in Japanese Buddhism, and that Buddhist monks
smoke. But what Buddhist monks should learn from this story is that they are requested to not only be a non-smoker, but also teach believers that neither tobacco
nor its imitation becomes an offering for deceased smokers who were killed/affected by using tobacco products themselves.
【Conclusion】 It is long way to go before Buddhist monks play an important role in doing advocacy work for a tobacco-free society in this country, but they
have a responsibility to do so.

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Overview of the Tobacco Control Coverage’ Communication Model in China

Jun SONG, Xuezheng JIN, Xiaobei LI
Chinese Center for Health Education
Objective: This study reviews the mass media coverage of tobacco control in order to formulate the strategies of mass media campaign.
Methods: Based on the collecting and coding of 110 awarded news works of the China Mass Media Tobacco Control Communications Initiative Program, we
conducted content analysis by analyzing the variables including the content and structure of coverage.
Results: The major sources of tobacco control coverage are Chinese government, public opinion leaders and TC institutes, and the proportion of the sum of
Public opinion leaders and Experts of the public health field (36.7%) supersedes the proportion of Government administrations (27.9%). Local and urban press(44%) is the major release channel of tobacco control topics. The issue distribution presented by the awarded news works has a proper richness. The coverage
focus mainly on institutes and public space (32%), appeal targets are abstract statements. The prime persuasion methods in awarded news works are visualization(40%) and fear appeal (28.6%).
Conclusion: A personified expression pattern is emerging in tobacco control coverage. In the future, media coverage of tobacco control should target a more
precise communication audience, and generate more contents, more expression styles and persuasion techniques.

P-S10-73

Smoke Free Tribal Districts: Results of a Sub National Compliance Survey in Himachal Pradesh, India

Ravinder KUMAR1, Pranay LAL1, Rana J. SINGH1, Salig R. MAZTA2, Narender SHARMA3
The Union South East Asia1, IGMC Shimla2, HPVHA Shimla3
BACKGROUND: Article 8 of FCTC and Section 4 of COTPA prohibits smoking in public places in India. State of Himachal Pradesh (population 7 million,
Area 55000 km2) presents a good model for tobacco control in India. Present study was conducted in November 2012 to assess the compliance with the smoke
free rules in two tribal districts (Lahul Spiti and Kinnaur) and assess the respective districts preparedness for smoke free declaration.
DESIGN/METHODS: An unobtrusive cross-sectional survey was done in 287 public places in district Kinnaur and 163 public places in Lahul Spiti. All
sampled public places was evaluated for five core criteria i.e. presence of signage, absence of active smoking, smoking aids, tobacco odour & smoking ash andcigarettes buts & bidi ends. The bench mark of 80% compliance was kept for the smokefree declaration.
RESULTS: In both district headquarters, compliance to signage was observed in more than 80% public places. Both districts demonstrated more than 80%
compliance in other four core indicators as well. Hospitality venues, bus & taxi stands and markets were the common places of violation. In both districtinstitutional mechanism of law enforcement is in place. The enforcement squads and other authorised person impose fines to the defaulters. There is high levelof awareness among the public about the law.
CONCLUSIONS AND RECOMMENDATIONS: Both districts has compliance of more than 80% in all the five core indicators, institutional mechanism isalready set up in both district. Hence district can be declared smoke free by the authorities. However, smoke free status has to be monitored carefully to sustain
it. Besides, this survey also identified the areas/potential points of violations in each jurisdiction which requires urgent attention from enforcement agencies.

P-S10-74

Effectively of Health Warnings on Tobacco Product Packaging to Reduce amount of Smoker-Students in Depok, West Java

Wilda Af’idah BITARI, Evi NURHIDAYATI
University of Indonesia
Background:
Junior and senior high school students (adolescence) are people that susceptible with using cigarettes, moreover, adolescence is a labile age. In province area,
West Java (includes Depok) placed on grade 12th as province with amount of smoker reach 37,7% (Basic Health Research 2010/Riskesdas 2010). Based on Basic
Health Research 2010 (Riskesdas 2010), percentage of junior and senior high school age that begin to smoke in West Java (includes Depok) is 10,1% for 10-14
years and 45% for 15-19 years. Knowing that percentage of smoker-students in West Java is high enough, that phenomenon indicates if students aren’t understand
too much about the danger of cigarette like mouth cancer, lungs cancer, impotence, and heart disease. That matter can gives negative effect for the quality of thenext generation in Indonesia, especially West Java, if in the amount of smoker-students increase continually.
Methods :This study using descriptive method by experiments to peer group of student in junior and senior high school around Depok city, West Java Indonesia. For
supporting descriptive methods combined with literature study to the similiar research.
Results :This research support by several thesis about student’s perception to health warnings in cigarrete package which are divided into two part positive and negative
perception. Student who has positive perception will receive the message and on the contrary student in negative perception will deny the health warnings.
Conclusion:
Knowing that the amount of smoker-students in West Java is high enough, then, we need to take research to decrease the amount of smoker-students in junior andsenior high school in West Java, especially in Depok. Because of that, we will take research with some junior and senior high school students in Depok as sample.
We will put health warnings on tobacco product. If that research effective, it can applied in province area moreover national because Indonesia government
haven’t make policy about labeling tobacco product with health warnings.
Keywords: cigarette, health warnings, smoker-students192

P-S10-75

Practical Tips for Maintaining a Strong Alliance

Saifuddin AHMED
Bangladesh Anti Tobacco Alliance
Establishing an alliance is relatively easy; maintaining it over many years is far more difficult. It is also important to consider how to evaluate success. For
instance, the Bangladesh Anti-Tobacco Alliance (BATA) has had the same coordinator since its founding in 1999, which some would say proves it is notsustainable, but the alliance remains healthy, in terms of the number of groups involved and active. The alliance is regularly able to mobilize 200 or more groups
for campaigns and events. BATA regularly organizes letter campaigns (including to MPs for tax increases), celebrates WNTD and since 2011 the National No
Tobacco Day, and engages in law monitoring and advocacy (including face-to-face meetings with government officials). Having an alliance greatly expands
access to policymakers because someone in the alliance (often a local NGO) typically has a good relationship with key people.
As to some of the secrets of BATA’s success, these include that the coordinator is highly accessible. WBB Trust provides strong secretarial support. The allianceis not project-based and does not receive funding; the work comes from the heart. It involves resource sharing and a strong spirit of volunteerism. The alliancefosters ownership by members, for instance by printing materials in names of different local organizations. The Secretariat serves as a drop-in center with staff
always available to meet members without a prior appointment. WBB stays open late, allowing many people to come by after work. WBB also engages inpractical mentoring: how to write a letter, create a banner, make a press release, do financial and narrative reporting, etc. WBB also creates opportunities formember organizations to participate in other trainings as well; provides support in applying for conferences/scholarships; and offers logistic support. Specificqualities of Secretariat staff include a friendly approach, flexibility, focusing on the positive and what all can contribute; and promoting sharing, encouragement,
and respect. BATA does not expect the same level of involvement from all organizations; rather it accepts what each can contribute. BATA also seeks to maintaindialogues to overcome problems. This involves allowing people to leave as well as inviting them to enter, and strengthening the alliance by making it more
decentralized. Although it is challenging to maintain an alliance, the payoff is huge in terms of greater strength for the work, creativity, energy, and even fun.

P-S10-76

How to Enlighten Both Smokers and Non-Smokers Who Have No Interest in Tobacco Problems- Through Our Experience to Manage One of The Largest Local World No Tobacco Day Events in Japan -Masataka KATO, Katsuhide OHASHI, Katsushi MURAYAMA, Akemi NOMURA, Yoko MIYAKE, Natsumi NAKAGAWA, Mai TANAKA,
Harumi MURAYAMA, Yoshiko WATANABE
Tobacco Free Ehime
Both smokers and non-smokers who have no interest in tobacco problems tend to stay away from World No Tobacco Day events. We often experience that only
smoking cessation activists take part in these kinds of events.
Niihama Medical Association sponsors a World No Tobacco Day event in Niihama, Ehime annually. We have used neither “Tobacco” nor “smoking cessation”
slogans for public information since 2009. Since 2010 we have offered popular comedians who belong to Yoshimoto Creative Agency (The most famous comedy
company in Japan) to appear on stage together with us to appeal against tobacco problems. Niihama City Office, Dental Association, Pharmaceutical Association
and TFE have cosponsored this event since 2011.
The highlight of this event is a live comedy show to tell the truth about tobacco. It must have been very unusual and shocking for audiences that popularcomedians talked each other about tobacco problems such as FCTC, pictorial warnings, tobacco tax and etc.
We also hold exhibitions, free consultation for health problems, free medical checks (exhaled CO monitoring, respiratory function test, bone mineral check);
face painting and games for children and so on at the lobby. Seven times the size of foreign tobacco packages printed pictorial warnings were used for games. So
children could understand the big difference in tobacco policy between advanced countries and Japan.
We make our own leaflets and colorful heart-shaped balloons with heart-shaped non-smoking signs highlighting tobacco problems. We distribute them with
non-smoking sign candies.
640 people came together at our event in spite of a direct hit of typhoon in 2011. 700 people gathered no matter how many regional sports day meetings were
held in almost all areas of the city in 2012.
We would like to sophisticate how we manage this World No Tobacco Day event so more people can gather and understand the risks of tobacco.

P-S10-77

Play the Role of Non-governmental Organizations, Fight against Tobacco Industry Interference with Tobacco Control

Guihua XU, Chao SUO
Chinese Association on Tobacco Control
In 2005, China's National People's Congress Standing Committee approved “World Health Organization Framework Convention on Tobacco Control (WHO
FCTC)” which came into effect on January 9, 2006 in China. Since then, China has officially began its comprehensive tobacco control performance. In the past
6 years, tobacco control has been struggling to move forward along with the continuous deepening of the performance. China Tobacco Control Association, as
China's tobacco control NGO, has been following the Convention over a long period of time, and sticks to MPOWER strategy, mercilessly exposing and resisting
tobacco company funding for schools and charity, sponsorship of cultural and sports events and activities and other donation from tobacco companies; tobacco
products promotional behaviour; disguised tobacco advertising in films and television dramas; cigarette packaging, and the "low tar" development of the tobacco
industry, etc., constantly promotes tobacco control efforts from the perspective of the civil society in China and carries out efforts to build a comprehensive
smoke-free society.
Keywords: Tobacco Control Smoke-free environment Tobacco industry interference193

P-S10-78

Non Aired Mass Media Tobacco Control Methods

Dilip K. ACHARYA1,2,3
Cancer Society of Madhya Pradesh1, GB Pant District Hospital2, Indian Medical Association-Indore3
Role of Mass Media Communication in Tobacco Control is well established. TV advertisements, scrolls, radio slots are undeniably the best, however TV ads
production & airing in prime time is a very costly affair. Many a times they are not in local language and are poorly understood by lay public.
Our society has been using other different methods of communication to enlighten public about the health hazards of Tobacco & quitting methods. We plan to
discuss in detail and show photos of these methods of mass communication:1. Hoardings:It is one of the cheapest as well as repeated viewing source of information dissemination
2. Posters-Displayed in short distance-eye level readable spot-the pictures/reading materials convey good message. Even release of posters by ministers/celebrity
gives a good coverage in print media & draws attention of public towards health hazards & law.
Our posters have been presented in International & National conferences & have won international awards also.
3. Pamphlets distribution in large public gatherings/religious fairs etc. The health dept.have distributed pamphlets to all patients attending govt.hospital OPD,sothat till the time they wait for their turn to see the doctor –they read the pamphlets and in the hospital they are in the best of their mind set to leave tobacco.
4. Glow Sign Boards
5. Rally’s
6. Print media-earned.
7. Symposiums/Lectures/Quiz etc.
And some other modes of communication will be discussed/displayed.

P-S11-01

The Impact of Tax Structure on Cigarette Prices: Findings from the ITC Project

Ce SHANG , Frank J. CHALOUPKA1, Geoffrey T. FONG2,3, Mary THOMPSON2, Richard J O’CONNOR4
University of Illinois1, University of Waterloo2, Ontario Institute for Cancer Research3, Roswell Park Cancer Institute4
1

Key Words: tax structure, tax avoidance, cigarette prices and price gaps
Background: Recent studies have shown that more opportunities exist for tax avoidance and brand switching when tax structure departs from a uniform specifictax. However, the impacts of tax structure on the distribution of cigarette prices and price gaps between higher- and lower- priced cigarettes have never been
empirically estimated in the previous literature. Our study, to the best of our knowledge, provides the first empirical evidence on such impacts.
Objective: This paper aims to estimate the impacts of tax structure on the price distribution measured by prices at a variety of percentiles and price gaps between
higher- and lower- priced cigarettes.
Methods: We used survey data from the International Tobacco Control Policy Evaluation (ITC) Project in 17 countries to conduct the analysis. Cigarette prices
are derived using the purchase information and aggregated to price and price gap measures for each country in a given year. The tax structures studied in thispaper include specific uniform, specific tiered, mixed uniform, mixed tiered and ad valorem tax structures. Their impacts on price gaps are estimated after
adjusting for GDP per capita and year trends. We also estimate how price gaps are influenced by the share of specific component among total excises and how
prices at various percentiles are associated with the amount of specific and ad valorem excises respectively.
Findings: Our investigation illustrates that, compared with specific uniform tax structure, specific tiered, mixed uniform, mixed tiered and ad valorem tax
structures are associated with greater price gaps. And an increase in the percentage of specific component among total excise taxes would decrease price gaps.
Moreover, an increase in the specific excises is associated with a higher increase in prices than an increase in the ad valorem excises. The results suggest thata uniform and specific tax structure is preferred in raising average cigarette prices and decreasing price gaps, which will lead to fewer opportunities for tax
avoidance and more effectiveness of excise taxes as a mean of reducing cigarette use.

P-S11-02

Factors Associated with Expected Tobacco Price Increase Needed for Quit Attempt: Findings from the ITC Korea Survey

Sung-il CHO , Susan PARK1, Eunja PARK2, Yeol KIM3, Hong-Gwan SEO3, Pete DRIEZEN4, Anne C.K. QUAH5, Geoffrey T FONG4,5
Seoul National University1, Korea Institute of Health and Social Affairs2, National Cancer Center3, University of Waterloo4, Ontario Institute for Cancer
Research5
1

Objectives: Tobacco tax policy aims at reducing demand for tobacco consumption, and it is important to predict the effect of tax increase to develop policy
strategies. We used data from the Waves 2 and 3 of the ITC Korea Survey, to assess the expected cigarette price increase which would make smokers attempt toquit. We also explored the factors associated with the required price increase.
Methods: In Wave 2 (2008), data for analysis included 1,224 smokers, excluding those who would never quit (n=461). Distributions of expected price were
examined, and multiple regression analysis on log-transformed price was conducted to identify associated factors. Cross-sectional analysis on pooled data ofWaves 2 and 3 as well as longitudinal analysis for changes between two waves will be performed. Interactions between individual characteristics and non-tax
policy-related variables will be explored.
Results: The expected price per pack that would make smokers attempt to quit was 6,816KRW on average, given the current price of 2,500KRW per pack. The
distribution of the expected price was highly skewed, with a prolonged tail toward the higher price. Higher expected price was associated with male gender,
younger age, living with a partner, higher household income, higher education, more cigarettes consumed per day (CPD), and higher scores of HSI (heaviness of
smoking index). The effects of CPD and HSI were smaller for older smokers aged 60 or over, compared to younger smokers.
Conclusions: Considering the large amount of increase required for quit attempt on average, tax policy needs to be combined with other policies to be effective,
particularly for heavy smokers with high nicotine dependence. Strategies for non-tax policies may need to be adapted for different subgroups depending on their
responsiveness to tax policy.

194

P-S11-03

Analysis of Correlation Between Smokers’ Income and Their Budget Allocation of Buying Cigarettes

Nurul M. RAHMAYANTI, Nurani P. EKAPUTRI, Muhammad KHAIRI
University of Indonesia
The prevalence of smoking in Indonesia is increasing overtime. Based on the latest research by World Health Organization and American Cancer Society, 70
percent from total male in Indonesia are smokers. Cigarette itself has a strong correlation with poverty. By the year 2006, the production of cigarettes reached
225 billion sticks and the largest consumer are the poor people. Based on Central Statistic Unite data on 2001, budget for cigarettes in people with high income
was only 7,5 percent from total income. In contrast, budget for cigarettes in poor people was 9,1 percent from total monthly income. There is also a trend in poor
people to sacrifice their daily needs, foods, and nutrition needs only for buying cigarettes. Based on data from Indonesian Forum on Parlianments for Population
and Development, 2 from 3 father in Indonesia are smokers and they spend their monthly budget for buying cigarettes stick by stick. From 19 millions poorfamilies in Indonesia, 12 millions of them have a smoker as their head of household. This is caused by the prize of cigarette which is very cheap in Indonesia
and reachable by them. They often buy it stick by stick, not a box of cigarette because they think it is cheaper. For example, if they smoke ten sticks each daywith the prize of each stick is Rp 500,-, they will spend Rp 23 trillion for cigarette and it is equivalent with the prize of 3,4 billion kilograms of rice. It is ironic
because they spend money to poison theirselves. Based on some medical researches, cigarette contains 4,000 chemical compounds with 250 of those compounds
are dangerous substances, and 50 of those substances are carcinogenic ones. Based on those problems, this study aims to analyze correlation between alocationof monthly budget with the income each month. This study combines literatur review from Ministry of Health Indonesia and in-depth interview with some
respondents. From this study, researches found that most of smoker are people with low income and they are willing to sacrifice their daily needs to buy cigarettes.
Keyword: Cigarettes, low income, Poor people, Smoker

P-S11-04

Pesticide Use in Thailand’s Burley Production: Health Costs Should be Realized

Jirawat JAROENSATHAPORNKUL
Srinakharinwirot University
The main purpose of research is to estimate the heath costs derived from the chemical pesticide use of the burley and rice production. The research area is
Srisumrong District, Sukhothai Province as the crucial cultivated area in Thailand. An accidental random sampling procedure is used to select and survey 130
households (i.e. 80 burley growers in Tubpeung Subdistrict and 50 farmers Banrai Subdistrict) from the research area. The survey is carried out using a standard
questionnaire with structured questions. The main results reveal that the insecticide has been in the type of highly hazardous regarding the criteria of World
Health Organization (WHO), the approximately 58.75% of the sample burley growers use. Unsurprisingly, since the high utilization rate of insecticide, pesticide
and herbicide in the burley production, the estimated health cost is about 369.19 Baht per Rai. Further, with respect to a statistically significance difference, it
is higher than the health cost of the rice production. The policy recommendations are as follows: (i) in each year Thailand Tobacco Monopoly should officiallypublish the toxicity of chemicals and pesticides for making decisions of the burley grower. (ii) The agricultural officer should consider on enhancing the land
productivity. This is because it is not only for total revenue increase. At the same time, it comes with the health costs increase. (iii) The biopesticide should beapplied for the tobacco farming. (iv) The rice is one of the alternative crops. Nonetheless, the volatility of price continues to be a major factor in the reductionof burley planted area in the long run.
Key words: Pesticide Use, Health cost, and Burley production

P-S12-01

Electronic Cigarettes Using Status and Relating Factors among Korean Adult Smokers: Findings from the International
Tobacco Control (ITC) Korea Survey

Yeol KIM1, Hong Gwan SEO1, Mi YAN2, Sang Mi KWAK3, Hyun-Suk JUNG3, Anne C.K. QUAH2, Geoffrey T. FONG2,4
National Cancer Center1, University of Waterloo2, Sungkyunkwan University3, Ontario Institute for Cancer Research4
Objectives: Electronic cigarettes (e-cigarettes) have been recently introduced and increasing in usage. E-cigarettes are advertised as a device that helps smoking
cession in Korea. However, information on the usage and harmfulness of them is limited. The aim of this study is to investigate the current usage and attitude ofe-cigarettes in Korean adult smokers and to analyze the association factors by using 2010 ITC Korea survey data.
Methods: The study was performed by telephone survey using random-digit dialing (RDD) methods during from October to December in 2010. The study
participants are adult smokers aged 18 years or older who have smoked more than 100 cigarettes in their lifetimes and who have smoked at least once in the past
30 days. For analyzing the association factors with e-cigarettes, we used the variables such as not only smoker’s characteristics but also participants’ attitudes tosmoking in the multivariate logistic regression model.
Results: The number of participating smokers is 1560. Among them, 79.8% of participants had ever heard of e-cigarettes. They heard about e-cigarettes throughTelevision or radio (43%), friends or relatives (33%), internet (8%) and newspapers and magazines (7%). Among smokers who have heard of e-cigarettes, 76.0%
thought e-cigarettes are less harmful than regular cigarettes, and 16.1% have ever used e-cigarettes. Among smokers who have never tried e-cigarettes, 36.6%
were interested in trying e-cigarettes. Most of e-cigarettes users bought them not from formal stores but from friends or relatives, somebody selling cigarettes
illegally and internet privately. From the results of multivariate logistic regression analysis, the higher level educated smokers had less experience or plan to use
e-cigarettes than the lower level educated smokers. However the smokers who had plan to quit smoking within 6 months and who worried much about smoking
harmfulness had used e-cigarettes or had a plan to use e-cigarettes.
Conclusion: Many of smokers who worry about smoking harmfulness and have plan to quit smoking. However, they think e-cigarettes are less harmful thanregular cigarettes and have willing of using e-cigarettes. Further studies will be needed on the harmfulness of e-cigarettes and on whether e-cigarettes can help
to quit smoking or make more addiction to smoke.

195

P-S12-02

The Potential of Tobacco (Nicotiana Tabacum) Extract and Methyl Eugenol as Green Organic Insecticide

Erna FEBRIYANTI, Yoga PRIASTOMO, Anki Novairi DARI, Wiwin SRININGSIH, Jumina JUMIA
Universitas Gadjahe-mail: erna_f@mail.ugm.ac.id
The use of synthetic pesticide to prevent the farm product quality reduction has been increasing due to pest and plant disease. However, organic pesticide has theessential role to exterminate pest without contaminating the environment and plant. This research was conducted to study the potential of nicotine and methyl
eugenol mixture towards the organic insecticide. Nicotine was extracted from the waste tobacco stem and leaves with maseration method using methanol andethanol 70% solvent. Identification of Nicotine was conducted using IR and GC–MS. Nicotine and methyl eugenol were mixed for 10 minute to get homogeneous
mixture. Laboratory bioassay trials were conducted to evaluate the organic pesticide “attract and kill” system against Carambola fruit fly, Bactrocera carambolae.
The organic pesticide with composition of nicotine and methyl eugenol (3:1) and (1:3) showed the highest fruit flies mortality in 24 hours and differ in mode ofaction in comparison with organophospate insecticide. The result clearly showed that nicotine has a promising potential as an environtmentally benign insecticide.
Keywords: insecticide, nicotine, methyl eugenol, tobacco

P-S13-01

Opinions of the Public and Tobacco Industry about the Ban on Sale of Gutkha and Paan Masala in India

Devika CHADHA, Narayan LAD, Nishi ARORA
Salaam Bombay Foundation
Context: Gutkha - which is a tobacco product containing areca nut, and paan masala – a non tobacco product containing areca nut are very popular products in
India. 14 Indian states have banned sale of above two products under “Food Safety and Standards Act, India (FSSAI)”. As per the Act, food products should notcontain any substance which may be injurious to health, and that tobacco and nicotine shall not be used as ingredients in any food products. Gutkha and paan
masala are considered as “food items” under the Act and contain harmful substances, hence cannot be sold to public.
Methods: Immediately after the ban on sale of gutkha and paan masala came into effect, a public opinion survey was conducted during one of the festivals in
India in September 2011, where large numbers of people were expected to gather. The survey questionnaire was an interviewer-administered one having basic
questions on demographics, and opinions about the ban and it’s after effects. The Indian smokeless tobacco industry responded on the said ban by way of a hugeadvertorial in leading national newspapers. The advertorial was also analyzed for its content that has potential to mislead the public.
Results: Survey results revealed that 95% of the respondents were aware of the ban, of which almost everyone felt that the ban was justified. 59% persons felt thatthe ban was justified because gutkha and paan masala are harmful for health. However, 84.8% respondents also warned that users of gutkha and / or paan masala
will switch to other tobacco products as a result of the ban. The Smokeless Tobacco Association, the Central Areca nut and Cocoa Marketing and Processing
Co-operative Ltd., and All India Kattha Factories Association issued a huge advertisement in national newspapers questioning the ban, declaring it as unfair, andchallenging its inclusion under the food laws of the country.
Conclusion: There is overwhelming public support for banning sale of gutkha and paan masala products, of which areca nut is an essential ingredient and known
to be a cause of oral cancer. However, there has been an upsurge of other non-tobacco products such as various brands of areca nut that are being packaged andlabeled in a manner very similar to the banned products. Also, the smokeless tobacco and areca nut industry are intervening into government policies and lawswith a view to mislead public and shift support in their favor.

P-S13-02

Retailer’s Behavior toward the Sale of Tobacco in a Community near a University in the Lower Northern Thailand

Chakgarphan PHETPHOOM1, Piyarat NIMPITAKPONG2Naresuan University1, Naresuan University2
Corresponding author: Chakgarphan Phetphoom email: pumanatural@hotmail.com
Many empirical evidences had confirmed that Thailand’s new smokers (Aged 15-24 years old) are increasing. Most accessible tobacco source is retailer near
their community. The objective of this cross-seconal survey was to investigate tobacco retailer’s sale behavior in a community near a university in the lower
northern Thailand. The samples were selected by convenient sampling (n=62). Data was collected by the research assistants (Aged over 20 years old) who
had been participated in the project workshop. Data collection novel methods included non-participant observation for recording types and location of tobacco
products. Retailer’s behavior as well as protocol of attempted to purchase cigarettes of retailers were recorded. The data was analyzed by using descriptive
statistic, percentage.
Results showed that most of the retailers in the commercial area distributed tobacco products to the student residences. The store types were grocery (45.2%),
mini-mart or convenience stores (40.3%) and Pubs / Bars (14.5%). Mostly, these retailers failed to ask about the consumers’ age or requested for ID card (95.2%).
Moreover, they sold individual cigarette (small pack) or no pictures /text about health warnings on cigarette packages to these young consumers (82.3%).
Approximately, 38.7% showed cigarette packages at point of sale or at visible shelf over the counter or outside the store.
In sum, retailers’ behavior toward tobacco sale in a community near a university in the lower northern Thailand was still the challenge issue. To improve thehealth promotion strategies concerning tobacco retailer’s sale, a betting health interventions needed to be designed. Ignoring retailer’s behavior which impacted
directly to the successful new smoker reduction, limiting youth access to tobacco could be failed to accomplish.
Keywords: retailer behavior, tobacco sale behavior, tobacco sale in a community196

P-S13-03

Hypothesis: The Tobacco Plant (Nicotiana Tabacum) Will Be Pathogen of Infectious Disease

Satoshi HIROTA
Osaka City Health Center[Hypothesis] The tobacco plant ( Nicotiana tabacum ) will be a pathogen of an infectious disease. The plant infects human brains, affects human intelligenceand causes defects in human behavior.
[Purpose] We human-beings will make tobacco selling illegal all over the world and will make tobacco pandemic finished by spreading the concept consisted of
the above hypothesis and by controlling the vector tobacco industry with getting the consensus of international society.
[Method] I applied the tobacco plant to the definition of infectious disease and confirmed three main factors of infectious disease.
[Result] The definition of infectious diseases could not be limited to microorganisms but could be spread to all living things. For example, a tapeworm wasdefined as an infectious disease as well. The concept of the “infection” could not be limited solely to “internal multiplication” of a pathogen but could also
include “external multiplication” like Staphylococcus aureus. The phenomenon of infection was not limited only to inflammation but also to non-inflammation
actions as like Bovine spongiform encephalopathy. So the tobacco plant (Nicotiana tabacum) could be included in these broadened definitions as well. The
first factor “the source of infection” was Nicotiana tabacum itself. The second factor “environment condition” was consisted of the combination of behavior
infection through mirror neurons and vector infection by tobacco industry. The third factor “host sensitivity” was said that younger people were more susceptible
to infection than older.
[Discussion] While HIV/AIDS confuses the human-immune-system, the tobacco plant confuses the human-thinking-system. The tobacco plant has deeply
infected the human brain, controlled human intelligence, and distorted human behavior. So we have not recognized it as infectious disease for a long time. All
countries (except Bhutan) have not resisted making tobacco illegal by implementing laws in many categories due to the brain infection. By spreading the concept
consisted of the above hypothesis, we will get the consensus of international society and control tobacco industry. We will make tobacco selling illegal all over
the world and will make tobacco pandemic finished. To control tobacco industry, we should expel the executives of tobacco industries and make other people
control the industries, using the power of the United Nations. We should regain the “captives held by Nicotiana tabacum involving tobacco industry workers.”

P-S14-01

An Experience with Direct Marketing Strategy Using Mobile Phone by a Tobacco Industry in Japan

Masako SHIGETA1,2, Isao WATANABE1, Daisuke MATSUI1, Kaoru INOUE1, Nahomi MIKAMOTO1, Atsuko AOKI2, Takashi DOI2, Narito KURIOKA2,
Tadaaki MORI2, Yuji YASUDA2
Kyoto Prefectural University of Medicine1, Kyoto Association for Tobacco Control2[Background] Tobacco companies target youth using various marketing strategies. Ten years ago, we collected many entry forms for draw and prize campaign
by Tobacco Companies, but recently there were very few entry forms.
[Purpose]Draw and prize campaigns by Tobacco companies seem to go under the radar. So we try to reveal their marketing strategy using mobile phone bymasquerading as a smoker.
[Material and Methods] We responded to a promotion “Get one accent to your style with these items” of Virginia Slim Accent by Phillip Morris as a smoker
and collected text messages and free tobacco packs from the company.
[Result] We inputted the QR code offered by Phillip Morris and sent personal information on 5/31/2011. Upon completion of the questionnaire we could entera draw for fashionable items such as a bag. After entering we began to receive text messages including further advertising with attractive photos and games
informing us of the different promotions, as follow; 7/13/2011(Massage Cushion for 1 pack), 9/26(Portable TV for 5 pack) and 10/3(Digital Camera for 5pack)
10/11(original earphone for 1pack), 10/17(coffee maker for 5 pack)and 10/24. All of these offered a ￥1000 gift card as a 2nd prize.
Following the messages we received three pack of tobaccos on11/18, 12/2 and 12/3 which invited us to enter another draw and prize campaign “Refresh yourwinter” for fashionable accessories. We also received messages with photos to promote the campaign on 1/16/2012, 2/10 and 2/13.
Six months later, we suddenly received a pack of tobacco “Marlboro Iceblast” on 7/9/2012. At last we received three pack of tobacco on 10/9, 10/10 and 10/11
with entry forms. The first prize of the campaign “Pearl Magic for you” was a tour to a Polynesian island and second prizes were a pearl necklace and earrings.
[Conclusion] The marketing strategies of the tobacco company are extremely shrewd and all-reaching. The campaign was long-running and we received a total
number of 7 packs of tobacco during a year. Researchers and advocates should immediately expose the insidious nature of such promotions.

P-S14-02

Advertisement Ban Enforcement in Cambodia: Survey in Three Provinces

Yibee HUANG1,2, Kong MOM3, Daravuth YEL4, Song-lih HUANG1,2
Taiwan International Medical Alliance1, National Yang-Ming University2, Cambodia Movement for Health3, WHO Cambodia4Introduction: Cambodia ratified the FCTC in November 2005. To fulfill its obligation on banning tobacco advertising, promotion and sponsorship (TAPS),
the Prime Minister issued a sub-decree to ban most forms of TAPS with a grace period of 6 months (till August 2011). Following a year of dissemination
activities through provincial level workshops, radio programs and on-site awareness activities, TIMA and CMH conducted a survey in 3 provinces to monitor
the enforcement of the sub-decree. Methods: The survey was conducted during October and November 2012; it targeted local law enforcers and points of sale
(POS) owners/managers using 2 self-developed questionnaires and a POS observation form. Three provinces (Takeo, Kampong Cham and Phnom Penh) wereselected based on intensity of intervention programs, tobacco industry activities, and feasibility concerns. Three to five districts in each province were sampled
randomly along the main roads. In each district, chiefs of community offices and heads of district-level departments were interviewed. POS were sampled basedon 5 business types (street vendor, grocery store, convenience store, restaurant and supermarket) and owners/managers were interviewed. On-site observation
was recorded during the interview. Results 1. 148 shop managers and 66 government officials were interviewed; no one rejected. 2. Large cigarette billboards
were not observed, but newly produced A4-sized posters and cigarette display shelves with promotional information and brand names were prevalent in POS,
especially in Kampong Cham, a major tobacco growing province heavily invested by BAT. 3. 143 out of 148 shops had some kind of promotional activities,
including single sales, free gifts, discount items, and coupons. 4. Most government officials were aware of the ad-ban sub-decree, mostly through TV (28%) andradio (22%) programs and dissemination workshops (21%), less from governmental channels (official meetings 19%; official letters 8%). While the awarenessseemed to be high, only few could recall any specific provision of the sub-decree. Discussion Enactment of the TAPS-ban sub-decree resulted in the removal ofoutdoor billboards and banners. However, new forms of advertisement and promotion emerged, partly by twisted interpretation and manipulation by the industryof the somewhat ambiguous wording in the sub-regulation of the said sub-decree. Inaction of both the local government officials and POS managers/owners
toward the sub-decree may be attributed to central authorities’ insufficient political will. Another factor may be the absence of standard enforcement protocol for
local officials. Further training on law enforcement is needed while awareness-raising activities should be continued. Acknowledgement The authors want tothank Taiwan’s Bureau of Health Promotion, Department of Health for its financial support to make TIMA’s projects in Cambodia possible since 2003.

197

P-S14-03

Mouth Freshener Serves Surrogate for Tobacco Products Advertisements in India?

Ravinder KUMAR1, Pranay LAL1, Rana J. SINGH1, Narender SHARMA2
Tobacco control1, Public health, HPVHA Shimla2
Background: Article 13 of FCTC and Indian anti-tobacco legislation prohibits advertisement of tobacco products. Tobacco industry is carrying out aggressive
advertisement of the non-tobacco products having same brand name and packaging design to tobacco products.
Objective:
To assess whether advertisements in Indian print media were for the intended products or serve as a surrogate for tobacco products.
Design/Methods: Three Indian vernacular newspapers in Himachal Pradesh- an Indian State were observed between 1st January to 31st March 2012, simultaneously
a cross sectional survey using a pre-tested checklist was also done across 720 tobacco shops in 12 district headquarters. These newspapers were screened again
between 1st October to 31st December 2012 followed by a survey across 388 shops in one of the district headquarter.
Results: In first phase, total 27 display advertisments (seven brands) of mouth freshener (also called pan masala- a non-tobacco product containing arecanut)
were seen. The advertised brand of mouth freshener was not available in any shop whereas gutkha (processed tobacco with lime) of same brand name andpackage design was being sold in 446 (72%) shops. In second phase, total 18 advertisements (four brands) of mouth fresheners were noticed. Field survey
revealed that total 322 (82%) shops have mouth fresheners which included the advertised products as well. However, total 73 (19%) and 209 (54%) shops werealso selling gutkha and zarda (raw tobacco product) of same brand name and package design.
Conclusions and recommendations: The mouth freshners advertisements serve surrogate for tobacco products through the print media in India. There is animmediate need for enforcement of complete ban on such advertisements

P-S14-04

KASH Surveys Seoul Retail Tobacco Advertising Trends

Eun Ji KIM, Hong Gwan SEO
Korean Association on Smoking or Health
A surveillance analyzed tobacco advertising in Seoul retail outlets. The surveillance was conducted around 1 month and monitored about 1,600 points of sales
in Seoul, 2012. Retailers included convenience stores, grocery stores and street tobacco stores. The purpose of this survey was to investigate whether the storeshas violated Korea Health Promotion Law.
Finding included the following:
30.5% of stores surveyed exposed their tobacco advertising to outside of the store.
38.8% of stores surveyed exposed their tobacco display to outside of the store.
46.0% of convenience stores surveyed and 26.1% of grocery stores surveyed exposed tobacco advertisement to outside of the store.
54.3% of convenience stores surveyed and 33.8% of grocery stores surveyed exposed tobacco display to outside of the store.
The average number of interior tobacco ads per store was around 7
According to the Korea Health Promotion Law, all point of sales must not expose their tobacco advertisement and tobacco display to outside of the store.
However over 30 percent of stores surveyed violated law in this study. Government should monitor local tobacco advertising and strengthen tobacco advertising
regulation.
Title: Delegitimizing tobacco industry sponsorship of primary schools in China“Genius comes from hard work, Tobacco helps you to be successful.” This slogan is plastered at theentrance of one of over a hundred primary schools sponsored by the Chinese tobacco industry. Throug
a campaign called “Project Hope,” Chinese tobacco companies fund schools and then name them after
their company or cigarette brand. In 2008, Chinese advocates began taking steps to have tobaccocompany names and brands removed from these schools. For example, the Thinktank Research Centerfor Health Development documented tobacco industry-sponsored Hope Schools across China, and, in
2010, the Chinese Association on Tobacco Control conducted a survey which found that children atthese schools held a favorable view towards the cigarette brand sponsoring their school. In 2012, theP-S14-05 Delegitimizing Tobacco Industry Sponsorship of Primary Schools in
China
Provincesof Jiangxi and Sichuan took action to remove the tobacco industry’s name and logo from Hop
Schools. From research to media advocacy to legal action, this presentation provides an overview of th
1
Miranda WANG , Yiqun WU
key advocacy strategies that led to the successful removal of tobacco company names in two provinces
and thecontinuing efforts
in 2013. Control3Campaign for Tobacco-Free Kids1, Thinktank Research Center for Health Development2, Chinese
Association
on Tobacco“Genius comes from hard work, Tobacco helps you to be successful.” This slogan isplastered at the entrance of one of over a hundred primary schools sponsored by the Chinese
tobacco industry. Through a campaign called “Project Hope,” Chinese tobacco companies
fund schools and then name them after their company or cigarette brand. In 2008, Chinese
advocates began taking steps to have tobacco company names and brands removed fromthese schools. For example, the Thinktank Research Center for Health Development
documented tobacco industry-sponsored Hope Schools across China, and, in 2010, theChinese Association on Tobacco Control conducted a survey which found that children atthese schools held a favorable view towards the cigarette brand sponsoring their school. In
2012, the Provinces of Jiangxi and Sichuan took action to remove the tobacco industry’s
name and logo from Hope Schools. From research to media advocacy to legal action, thispresentation provides an overview of the key advocacy strategies that led to the successful
removal of tobacco company names in two provinces and the continuing efforts in 2013.

“天才出于勤奋，烟草助你成才” -四川烟草希望小学“Genius comes from hard work
Tobacco helps you to be successful” - Sichuan Tobacco Hope Elementary School198

P-S14-06

Curbing Surrogate Tobacco Advertisements at Public Transport Systems and during Festivals in Mumbai

Tshering BHUTIA, Devika CHADHA, Narayan LAD, Rajashree KADAM
Salaam Bombay Foundation
Background and Objectives: Until recently, advertisements of “pan masala” products bearing same name and packaging as “gutkha” products were observed at
public transport systems in Mumbai. Unlike gutkha, pan masala does not contain tobacco, thereby being perceived as ”harmless alternative” to gutkha. Taking
advantage of this perception, Indian smokeless tobacco industry increased pan masala advertisements over the years. While direct tobacco advertisements
were banned, those of pan masala continued, suggesting their non-tobacco nature. Salaam Bombay Foundation (SBF) conducted a study to understand productassociation, that is whether general public perceived advertised pan masala brands with names similar to gutkha products as being non-tobacco or tobacco
products.
Methods: A survey was conducted in Mumbai in May 2011, among 3000 respondents (1500 children aged 12 to 18 years and 1500 adults aged 19 to 50
years). Respondents were shown flash cards of advertised pan masala brands – “Goa 1000”, “RMD” and “Rajshree”. Based on these results, a demand charter
was submitted by SBF children to appropriate government authorities for action. In July 2011, an evaluation was done to assess status of displayed outdoor
advertisements of pan masala products with names and packaging similar to gutkha products on buses and bus stops.
Results: All three brands – “Goa 1000”, “RMD” and “Rajshree” were identified as gutkha instead of pan masala by respondents. 82% children and 84% adults
identified the flash card of pan masala brand “Goa 1000” as gutkha. SBF children conducted advocacy meeting with Superintendent of Bombay Municipal
Corporation (BMC). As a result, BMC issued official letter to all vendors to restrict display of surrogate advertisements for tobacco products. Within a month,
all pan masala advertisements, promoting corresponding tobacco products were removed.
Conclusion: Tobacco industry finds ways to market its products to public. Development of an evidence base against the industry provides a platform tostrengthen advocacy efforts with relevant stakeholders, adoption of policies and their effective enforcement.

P-S14-07

Denormalization of CSR Tobacco Industry in Thailand

Chulunee PICHAYAKUNMONGKOL
Thai Health Promotion Foundation
As a result of Thailand’s banning of all forms of tobacco advertising promotion and sponsorship, the tobacco industries have engaged in many so call corporatesocial responsibility activities such as school student projects, community projects, environmental issue etc.
Non of these CSR activities address the health and economic impact of smokers and family, which should be the primary recipient of corporate social
responsibility activities. Local sampling of public opinion among students and community reveal positive attitude toward tobacco industries CSR activity. A
proposal to ban tobacco industry CSR by law has received opposition from some communities as well as some decision maker.
To counter these trends, Action on Smoking and Health, Thailand initiated a project title “Denormalization of Tobacco Industry CSR Activity”
Objective
1. To publicise the real purpose of tobacco industry’s CSR activities.
2. To advocate for the restriction or ban of CSR activities by tobacco industry in accordance with FCTC Article 5.3 and Article 13 guidelines.
Activities
1. Establish a working group for the denormalization of tobacco industry’s CSR.
2. Prepare factsheet, campaign materials.
3. Organizing forum to educate the media/public.
4. Organizing Youth Forum on countering tobacco industry CSR.
5. Distribution of campaign materials to education institute.
6. Produce New Media on tobacco industry CSR.
7. Advocate to include ban of tobacco industry CSR in the draft tobacco control law.
Expected Outcome
1. Public awareness of the real purposes of tobacco industry CSR increase.
2. A growing network of individual /organization disapprove or reject tobacco industry CSR.
3. Policy makers approve the law on banning tobacco industry CSR.

P-S14-08

Institutional Defects in the System of Evaluation and Monitoring of Tobacco Products in China

Quan GAN , Gonghuan YANG2
International Union Against Tuberculosis and Lung Disease, Beijing1, Peking Union Medical College2
1

The agency responsible for the monitoring and evaluation of the safety of tobacco products in China is directly affiliated with the Zhengzhou Tobacco ResearchInstitute, which is owned by the China Tobacco Corporation. This setup of self-monitoring virtually eliminates transparency and objectivity from the process
and is an obvious conflict of interest and in violation of the FCTC. The evaluation methods used by the agency are also obsolete. Chemical analysis of tobaccosmoke constituents under the outdated ISO method and limited toxicological assessment are the sole measures against which the safety of products are evaluated.
Health claims for certain "novel" products, mostly low-tar and herbal cigarettes, are also based upon such standards. The tobacco industry takes advantage ofthese loopholes in the evaluation system to promote the "less harm, low tar" campaign and makes profit from selling so-called "healthier" cigarettes. The researchachievements of a tobacco industry researcher who was recently elected to the Chinese Academy of Engineering are also largely based on the faulty evaluation
standards of the agency. One needs to be aware, on the other hand, that the institutional defects of the monitoring and evaluation system roots back to the tobacco
monopoly, which has a double identify of a national tobacco company and the government agency overseeing it. This paper, taking the "US FDA Draft Guidanceof Modified Risk Tobacco Product Applications for Industry" as reference, analyzes the gaps in the monitoring and evaluation of tobacco products under thecurrent system and offers recommendations for reform.

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David versus Goliath: Denormalizing CSR activities of the Tobacco Industry in the Philippines

Irene Patricia N. REYES1
HealthJustice
Background: The Philippines is targeted by the tobacco industry for its so-called CSR activities. In 2010, the government issued a policy implementing Article
5.3 of the FCTC, including a prohibition against unnecessary interactions with and receipt of gifts, donations, or sponsorships from the tobacco industry.
However, the tobacco industry is able find ways to circumvent the policy. As the country moves towards implementation of stricter policies in tobacco control, italso needs to address the new challenges subverting the implementation of Article 5.3. Methods: This research reviews the strategies in denormalizing tobacco
industry’s so-called CSR activities. It also analyzes the emerging norms in corporate accountability to strengthen tobacco industry liability in conducting CSR
activities in light of the United Nations Guiding Principles (UNGP) on Business and Human Rights. Results: Policies implementing Article 5.3 of the FCTC
were instrumental in reducing donations and partnerships between the tobacco industry and the government. Shortly after these were issued, national and local
officials reported termination of partnerships with the industry and rejection of donations. Undaunted, the industry was quick to adapt by coursing its donations
to civil society organizations (CSOs). In 2011, Philip Morris Fortune Tobacco Corporation doubled the amount it spent on CSR activities compared to theprevious year. Hence, while there have been less partnerships with the government, the policies hardly made a dent in terms of reducing the publicity of thetobacco industry CSR activities. Advocacy campaign targeting CSOs is promising and a substantial number already made a stand to reject donations from thetobacco industry. But, there are reputable organizations that still continue their partnership with the tobacco industry due to lack of funding for their programs.
Reframing the FCTC within the context emerging norms on the corporation’s responsibility to respect human rights and applying the UNGP provides additional
basis to subject strategies of the tobacco industry in greater scrutiny. There is a need to look into instances where tobacco industry uses its donations as an entry
point to lobby to the government or conducts below-the-line tactics in circumventing ban on tobacco advertising by publicizing its CSR activities. Conclusion:
While policies implementing Article 5.3 have been successful in prohibiting unnecessary interactions with the tobacco industry and prohibiting CSR donations
to government agencies. The limited scope creates a loophole and an opportunity for the industry to use private organizations to continue conducting andpublicizing its so-called CSR activities. These new challenges need to be addressed. The government and civil society organizations must be more aggressive inits campaign to denormalize tobacco industry tactics and push for a ban on CSR activities by the tobacco industry.

P-S15-01

Perceptions of Health Warning Labels for Smokeless Tobacco Packages in India and Bangladesh

Seema MUTTI1, David HAMMOND1, Jessica L. REID1, Prakash C. GUPTA2, Mangesh PEDNEKAR2, Hemlata SHEDGE3, Nigar NARGIS3,
AKM Ghulam HUSSAIN3
University of Waterloo1, Healis-Sekhsaria Institute for Public Health2, University of Dhaka3
Background: Increasingly, the global burden of tobacco use is borne by low-and-middle income countries (LMICs), such as India and Bangladesh. India and
Bangladesh have more smokeless tobacco users than the rest of the world combined. Health warnings on product packaging are among the most cost-effective
policy interventions; however, there is little research to guide regulators in LMICs on selecting content, particularly for smokeless tobacco. The current study
was among the first to examine perceived effectiveness of health warnings for smokeless tobacco in India and Bangladesh.
Methods: An experimental study was conducted in India (n=1,002) and Bangladesh (n=1,081), with adult (19 years and older) smokeless tobacco users,
and youth (16 to 18 years) users and non-users. Respondents were randomly assigned to view smokeless tobacco health warnings according to one of four
experimental conditions: 1) text-only, 2) pictorial warning with symbolic imagery, 3) pictorial warning with a graphic health effect, or 4) pictorial warning witha personal testimonial. Each respondent viewed five warnings within that condition for the following health effects: 1) oral cancer, 2) mouth disease, 3) heartdisease, 4) addiction, and 5) death, and rated each warning on a scale of 1 to 10 for perceived effectiveness. A linear regression model was run, controlling forcountry, smokeless tobacco use, and sex.
Findings: Text-only warnings were rated as less effective than all of the pictorial styles: symbolic imagery, graphic health effects, and personal testimonials(β=.36, p<.001, β=2.39, p<.001, β=1.88, p<.001). Graphic health effects and personal testimonials were given higher ratings compared to warnings with symbolic
imagery (β=2.03, p<.001, β=1.52, p<.001). Graphic health effects were given higher ratings than personal testimonials, (β=.50, p<.001). Adults gave higher
ratings than youth (β=.32, p=.002), and females gave higher ratings than males (β=.16, p=.02). No significant differences were observed between countries or
between smokeless tobacco users and non-users (among youth). Findings will also be presented on the effectiveness of different health effects.
Conclusions: Pictorial smokeless tobacco warnings are more effective than text-only, and graphic health effects may have the greatest impact overall, consistent
with research from high-income countries on cigarette warnings.
Funding: International Development Research Centre (105136-008). Additional funding: NIH (P01 CA138-389-01, the Propel Centre for Population HealthImpact, a Canadian Institutes of Health Research (CIHR) New Investigator Award (Hammond), the CIHR Training Grant in Population Interventions for Chronic
Disease Prevention (Mutti), the Ontario Graduate Scholarship (Mutti), and the CIHR Doctoral Award (Mutti).

P-S15-02

Plain Packaging on Intention not to Smoke among Thai Youths

Nithat SIRICHOTIRATANA, Chukiat VIWATWONGKASEM, Dusit SUJIRARAT, Pratana SATITVIPAWEE, Naruemon AUEMANEEKUL,Malinee SOMPOPCHAROEN, Pimpan SILPASUWAN
Mahidol University
Introduction: Experts consider packaging to be one of five key components of successful marketing, along with product, price, place, and promotion. Plainpackaging will reduce deception on the package, while increasing the power of health warnings.
Objectives: of this study are to evaluate youths’ perception on health warnings between plain and regular packaging on self confidence regarding not smoking.
Method: Descriptive research design with multistage stratified random sampling was employed. A total of 1,239 self-administered questionnaires were collectedfrom randomly selected students, between the age of 15-24, and residing in 4 provinces, representing each geographical region of Thailand, and Bangkok
metropolitan.
Results: Results indicated that the group of those who never smoke (including those already quit smoking) strongly agreed that plain packaging would potentiallymotivated their confidence not to smoke in the future. Results from logistic regression analysis indicated that non-smoking group had a higher level of perceived
susceptible health risk 3.53 times of confidence on not smoking, comparing to the current smokers group (OR = 3.53; 95% CI = 2.18-5.70; p<0.001). On
perceiving severity of diseases due to cigarette smoking, non-smoking group had a higher level of intention not to smoke with 2.86 times compared to current
smokers group (OR = 2.86; 95% CI = 1.92-4.26; p<0.001).
Conclusions/Recommendations: Plain packaging has significant influences on non-smokers not to smoke, and can positively motivate current smoking youths
to quit or reduce smoking.
Keywords: Plain packaging, Tobacco control, youths, smoking
Acknowledgement: Funding for this research was fully supported by Tobacco Control Research and Knowledge Management Center (TRC) and Thai Health
Promotion Foundation (ThaiHealth).

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P-S15-03

The Effectiveness of Health Warnings in China: Longitudinal Findings from the ITC China Survey

Geoffrey T. FONG1,2,3, Lin XIAO3, Yuan JIANG3, Qiang LI1,3, Pete DRIEZEN1, Lin LI4, Hua YONG4
University of Waterloo1, Ontario Institute for Cancer Research2, Chinese Center for Disease Prevention and Control3, The Cancer Council Victoria4
The 176 nations that have ratified the WHO Framework Convention on Tobacco Control (FCTC) are obligated to implement strong, prominent health warnings
on tobacco packaging. According to the Article 11 Guidelines, adopted in November 2008 by the Conference of the Parties, these warnings should be at least 50%of the top of the front and back of the pack, include pictorial images, be graphically distinct from the package design, include a range of specific diseases arisingfrom the tobacco product, provide information about cessation, and information about the harmful effects of tobacco smoke pollution (also known as secondhand
smoke). None of these features were incorporated into China’s October 2008 revision of their text-only warnings. A policy analysis of China’s warnings leads tothe conclusion that these warnings should show limited increases in effectiveness. The present paper is to our knowledge the first population-based evaluation of
the effectiveness of China’s health warnings as measured among smokers themselves. We analyzed three waves of the ITC China Survey, a longitudinal cohortof a representative sample of 800 smokers and 200 non-smokers in each of 7 cities in China—Beijing, Shanghai, Guangzhou, Shenyang, Changsha, Yinchuan,
and Kunming (added at Wave 3), conducted in 2006, 2007–08, and 2009. The ITC China Survey is a part of the larger ITC Project, which is conducting similar
longitudinal cohort surveys in a total of 22 countries. Findings over time showed that the Chinese health warnings introduced in 2008 (between Wave 2 andWave 3) led to increases in some of the key indicators of warning effectiveness (including noticing of warnings, thinking about the health risks of smoking,motivation to quit, forgoing a cigarette because of the warnings, and other indicators that the ITC Project has validated across countries). However, the magnitudeof effect was much lower than that found in other countries that have implemented warnings consistent with the Article 11 Guidelines (e.g., Thailand, Malaysia,
Mauritius, Australia). The findings for implementation of health warnings in China are consistent with findings in other policy domains in China: that the FCTC
implementation in China is characterized by slow and small incremental changes, far from the strong impact shown in other countries that have implemented
policies indicated in the FCTC Guidelines.

P-S15-04

Challenge in the Implementation of 75% Pack Warning: An Example of Tobacco Industry Interference

Shanta L. MULMI
Resource Centre for Primary Health Care
Purpose : The purpose of this paper is to analyze how the Industry Interference can make further delay in the implementation of Tobacco Control and Regulation
Law.
Method : A thorough study has been made in the procedural delay in implementing the article 9 of the Tobacco Control and Regulation Law. This law alongwith all the articles have to be implemented within November 2011. But a total of 11 different tobacco industries and distributors filed separate court cases in theSupreme Court challenging the legal provision of 75% health warning.
The Supreme Court hearing is in process. Because of the dissolution of Constituent Assembly (Parliament) in May 2012, the appointment of Supreme Court
Judge could not be completed. The Supreme Court at present has only 6 judges which is less than 40% of its total requirement. This has further delayed the
judicial procedure. The Industry Interference is the main challenge.
The National Pressure Group against Tobacco and Health Rights and Tobacco District Network are coming to the street for timely court decision.
The Health Journalist Group has also been mobilized to provide the information to general public clarifying the confusion created by the tobacco industry for
their personal benefit. The lobby from the tobacco industries are clearly visible.
Result : The most progressive article of the law of Asia which asks for 75% of the total area of tobacco packets for pictorial health warning could not be
implemented. Delay in Justice is No Justice.
Conclusion : This incident shows that there is a need for more strong solidarity of Anti-tobacco advocacy organizations to challenge the Industry Interference
and make court decision in favour of the public health.

P-S15-05

Wear-outs Effects on the Malaysian Pictorial Health Warnings: Findings from the International Tobacco Control Policy
Evaluation (ITC) Malaysia Project

Zarihah ZAIN1, Maizurah OMAR2, Rahmat AWANG2, Noor Afiza Abd. RANI2, Sazaroni Md. RASHID2, M Nazri M. TAHIR2, Shalihin M SAMIN2,
Anne C. K. QUAH3, Geoffrey T. FONG3,4, Ron BORLAND5
Malaysian Women’s Action for Tobacco Control & Health (MyWATCH)1, Universiti Sains Malaysia2, University of Waterloo3, Ontario Institute for Cancer
Research4, The Cancer Council Victoria5
Introduction: Consistent with WHO FCTC, the Malaysian government introduced six pictorial health warnings for cigarettes in January 2009. The healthwarning designs (i.e. mouth cancer, throat cancer, lung cancer, premature birth, miscarriage and gangrene) must cover 40% and 60% respectively on the front
and back of each pack. However since its introduction, these warnings have not been changed. Past studies have shown that replacing pictorial health warnings
every two years is associated with increase effectiveness. Objective: Objective of this study is to examine the wear-out effects of the Malaysian pictorial healthwarnings in terms of ‘noticing’, ‘thoughts about perceived health risks of smoking’, ‘emotional feelings’, and ‘quit intention’ among Malaysian adult males
from 2009 to 2012. Methodology: Data were obtained from the fourth and fifth waves of a cohort study using stratified multistage-cluster sampling, conducted
in 2009 and 2012 respectively. A total of 2,049 adult smokers were recruited (Wave 4) from July to Dec 2009 and 2,020 adult smokers in Wave 5 (Mei 2011 toJanuary 2012). Wear-out effects relating to ‘exposure to pictorial health warnings’, ‘reading/looking closely’, ‘thinking about perceived health risks of smoking’,‘label made you feel’, and ‘label made you more likely to quit smoking’ were observed. Result: There was slight increment in the ‘noticing of health warnings’
from 2009 (65.8%) to 2012 (67.6%). However, other effect measures were seen to be declining after 2 years and these were ‘reading or looking closely’ (54.4%
to 42.7%), ‘thinking about health risk of smoking’ (61.2% to 48.8%), and ‘likely to quit smoking’ (53.8% to 41.7%). When introduced in 2009, approximately
70% of smokers said Malaysian pictorial health warnings were realistic and lead them to feel alarmed, unpleasant and also worried, but in 2012, the effects on
feelings have dropped to below 55%. Conclusion: The effects of Malaysian pictorial health warnings on cigarettes packs are wearing out among adult smokers
in terms of ‘noticing’, ‘thinking of health risks’, ‘feelings’, and ‘intention to quit’. Thus, there is urgent need to replace these in order to improve effectiveness
ACKNOWLEDGMENT: The ITC-SEA Project is supported by grants P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center), R01
CA100362 from the National Cancer Institute of the United States, Canadian Institutes of Health Research (79551), Ontario Institute for Cancer Research,
ThaiHealth Promotion Foundation and Ministry of Health Malaysia. We would also like to acknowledge the other members of the ITC Project team.

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Prevalence and Predictors of Misperceptions About “Light” and “Low-Tar” Cigarettes: Findings from the ITC Korea
SurveyAnnika C. GREEN1, Geoffrey T. FONG1, Tara ELTON-MARSHALL1, Hong Gwan SEO2, Yeol KIM2
University of Waterloo1, National Cancer Center2
BACKGROUND: “Light” and “low-tar” cigarettes have been promoted as alternatives to “full flavour” or “regular” products, and marketed in ways that haveled consumers to wrongly believe that they are less harmful. Whereas many smokers in Western countries perceive “light” and “low tar” (hereafter referred toas “LLT”) cigarettes as less harmful, few studies have investigated whether similar perceptions exist in non-Western countries, where LLT brands are prevalent.
This study focuses on perceptions about LLT cigarettes in the Republic of Korea, a country that has not banned such descriptors as called for under Article 11of the WHO Framework Convention on Tobacco Control (FCTC).  AIM: To assess the prevalence of misperceptions among Korean smokers that LLT brands
are less harmful than regular brands. METHODS: We analysed data from Wave 3 of the ITC Korea Survey, a representative national sample of 1753 smokers
conducted during October–December 2010. In addition to questions assessing beliefs about LLTs, there were additional questions that were used as predictors of
those beliefs: a) demographics, b) health knowledge, c) health concerns, and d) quitting behavior. RESULTS: 25.0% of smokers believed that light cigarettes
are less harmful compared to regular brands, and 30.1% of smokers believed that those who smoke light cigarettes take in less tar. 39.5% of smokers believedthat light cigarettes are smoother on the throat and chest. In a weighted logistic regression, the strongest predictors of the belief that LLT cigarettes are lessharmful were: the belief that smokers of light cigarettes take in less tar than smokers of regular cigarettes (p<0.001, OR=8.41, 95% CI: 4.05–17.47) and that lightcigarettes feel smoother on the respiratory system (p<0.001, OR=7.74, 95% CI: 3.79–15.79). More educated smokers (more than high school) were more likely
than less educated smokers to believe that light cigarettes are less harmful (p<0.001, OR=8.20, 95% CI: 3.24–20.74). None of the other predictors, including
concern for health, health knowledge, or level of self-reported addiction were significant predictors.  CONCLUSIONS: Despite research evidence that LLT
cigarettes are no less harmful than regular brands, Korean smokers continue to believe that these cigarettes are less harmful, and at levels that are higher thanin Western Countries (approximately 15-20%). These results indicate that the Republic of Korea should ban not only labels such as “light” and “low-tar”, butalso other methods that the industry has used to wrongly communicate to consumers that certain brands are less harmful—such as the use of lighter colors, tar
numbers and other such methods. Ultimately, plain packaging is likely the most effective strategy to minimize these deceptive practices. Finally, the fact that
beliefs about smoothness were so strongly tied to beliefs about harmfulness suggests that there may also be a need to remove cigarette design features that reduceharshness, such as menthol and other flavorings.

P-S15-07

Inter-Rater Reliability Study of Pack Identification to Determine Illicit Cigarettes in 3 ASEAN Countries

Kin FOONG , Yen Lian TAN2, James Michael BOWLING3, Anthony SO4
Universiti Sains Malaysia1, Southeast Asia Tobacco Control Alliance2, University of North Carolina3, Duke University4
1

Background
Illicit tobacco trade is a growing concern among policy makers as it contributes to enormous losses of government revenue. Obtaining reliable estimates ofillicit tobacco trade would support implementation of WHO FCTC Article 15. There are various methods to measure illicit tobacco trade. One such method is tocollect cigarette packs from smokers and identify features on the pack that defines it as locally illicit or not. The reliability and validity of this approach is vital in
obtaining an accurate estimate of extent of illicit cigarette consumption. This paper presents results of an inter-rater reliability study of this method.
Methods
A cross-sectional study of smokers recruited from households was conducted in Thailand, Indonesia and Vietnam to determine the magnitude of illicit cigarette
consumption. A representative sample of over 2000 smokers was chosen from selected study areas within each country. Over 95% of respondents in all countries
provided an empty cigarette pack of the last purchase. A tool was designed to identify illicit features of each pack such as absence of genuine tax stamp and local
health warnings.
An inter-rater reliability study was conducted in each country to evaluate if the coding scheme devised to identify cigarette packs as locally illicit or not isunambiguous, and capable of producing a consistently reliable coding. All (100%) illicit packs and a random sample of 10% of the non-illicit packs identified
during the field surveys were verified by new coders. Two measures of inter-rater reliability were used: percent agreement and kappa.
Results
Percent agreement in coding of all stamp and pack features within each country are between 85 and 100 %. Kappa coefficient is over 0.90 for almost all stamp
and pack features. The primary predictor of illicit cigarette packs in all 3 countries is the absence of a government excise tax stamp on the cigarette packs.
Conclusion
Inter-rater analyses show the coding of stamp and pack characteristics in the 3 countries was highly reliable and consistent. The coding scheme devised to identify
cigarette packs as locally illicit or not is unambiguous, and capable of producing a consistently reliable coding.

P-S15-08

Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of anExperimental Study in Four Asian Countries

Jessica L REID1, Seema MUTTI1, David HAMMOND1, Prakash GUPTA2, Qiang LI3, Jiang YUAN3, Nigar NARGIS4
University of Waterloo1, Healis-Sekhsaria Institute for Public Health2, Chinese Center for Disease Control and Prevention3, Bureau of Economics, Universityof Dhaka4
Background: Cigarette package health warnings are a potentially important means of communicating the health risks of smoking. Many countries, including China, Bangladesh,
and Korea, have text-only warnings that contain general information (e.g., “smoking is harmful”), while others, such as India, have implemented pictorial warnings. This analysis
examines beliefs about the health effects of smoking among adults and youth in four countries - China, India, Bangladesh, and South Korea - and whether viewing health warnings inan experimental study influences such beliefs. Methods: Survey data were collected from n=1070 respondents in Figure 1. Percentage of respondents in each country who believed that smoking causes each of 12 health effects
China (504 adult male smokers, 566 male and female youth age 16-18), n=1012 in India (503 adults, 509 youth),n=1018 in Bangladesh (513 adults, 506 youth), and n=1362 in Korea (621 adults, 741 youth). A web-based survey
was conducted in Korea, with computer-assisted face-to-face interviews in all other countries. Respondents wererandomized to view and rate pictorial health warnings for 2 (of 15) different health effects, after which they reported
beliefs about whether smoking caused 12 health effects (yes/no/don’t know/refused). Differences in health beliefs
between those who had and had not viewed health warnings relevant to each health effect were tested using Chi
square analysis. Results: Knowledge of some health effects was high (e.g., >90% of respondents in all countries
believed smoking caused lung cancer), but was much lower for others, such as gangrene, impotence, and stroke.
Youth and adults reported similar levels of beliefs in India and Bangladesh, whereas greater differences between
youth and adults were observed in China and Korea. A significantly greater proportion of respondents who viewed
relevant health warnings (vs. not) believed that smoking caused that particular health effect, for 6 health effects in
China (heart disease, stroke, mouth cancer, emphysema, gangrene, impotence), 7 in Korea (heart disease, stroke,mouth cancer, throat cancer, emphysema, gangrene, impotence), and 3 in each of India (gangrene, impotence,
aging) and Bangladesh (gangrene, impotence, throat cancer). Viewing relevant warnings had the greatest influence
for health effects that were least known. Around three-quarters of respondents in each of China, Bangladesh,
and Korea said that cigarette packages should have more health information than they do now, compared toapproximately half of respondents in India (which currently has pictorial warnings). Conclusions: Pictorial healthwarning labels that convey the risk of specific health effects from smoking can increase beliefs and knowledge
about the negative health consequences of smoking, particularly for health effects that are lesser-known.
*=significant difference (at p<0.05) between % belief among those who saw the relevant warnings vs. not, within country
China - viewed relevant set
Bangladesh - viewed set

China - did not view
Bangladesh - did not view

India - viewed relevant set
Korea - viewed relevant set

India - did not view
Korea - did not view100%

% of respondents who believed that smoking causes health effect

90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

Lung Cancer

Heart
DiseaseStrokeMouth
CancerThroatCancerEmphysema Gangrene Impotence
Health Effect

202

Aging

Death

Harm tounbornbabiesLung cancerfrom SHS

P-S15-09

Fear Arousal towards Pictorial Health Warning on Cigarette Plain Packaging among Thai AdolescentsMalinee SOMPOPCHAROEN, Chukiat VIWATWONGKASEM, Pratana SATITVIPAWEE, Dusit SUJIRARAT, Narumon AUEMANEEKUL,
Pimpan SILPASUWAN, Nithat SIRICHOTIRATANA
Mahidol University
Background and objectives: Since, Cigarette Plain Packaging (CPP) was expected to limit brand image of cigarette pack, this study aims to examined theperception of teenagers on the design, color (green, brown, white and black), words, and health warning picture (HWP) of the new plain cigarette package, whichtries to promote the fear feeling of smoking.
Methodology: Mixed method research with two phases demonstrating sequential design approach with multistage stratified random sampling was conductedin Bangkok Metropolitan and other four provinces representing each region of Thailand. The 1,236 respondents, both college and high school students, wereselected and complete self-administered questionnaires to assess the HWL on the new CPP and the linkage to their perception towards cigarette consumption .
According to the respondents, there were 805 respondents who never smoke, 225 respondents who quit smoking, and 225 respondents who are current smokers.
Results: All three groups of respondents insisted that the HWP on new CPP can lessen the demand for cigarette use. According to the HWP on new CPP, it wasreported that the most frightening HWP to the respondents were oral cancer, lung cancer, and laryngeal cancer, respectively. Furthermore, the most fearful HWP
on new CPP was revealed to be in black color. In addition, Among those who never smoke; fear arousal scale was statistical significantly higher than that of othertwo groups (P<0.001). Significantly factors predicting fear arousal of non- smokers were HWP on CPP that motivated them not to buy cigarette, and color of
CPP that teens selected. R2 changed =76.2%. while as smoker and quitted smokers; factors predicting fear arousal were perception toward HWP on new CPP ,interpreting dangerous effect that obtained- information from HWP, wasteful smoking opinion, and color of packaging. R2 changed =21.5%.
Conclusions/Recommendations: The HWP on new CPP can raise fear arousal feeling among teenagers, potentially leading non-smokers to not smoke in the
future, as well as, helping current smokers to reduce or even quit smoking.
Keywords: Cigarette plain packaging, Fear arousal, Color and pictorial health warning label.
Acknowledgement: Funding for this research was fully supported by Tobacco Control Research and Knowledge Management Center (TRC) and Thai Health
Promotion Foundation (Thai Health).

P-S15-10

Images of Cartoon Characters and Celebrities on Areca Nut Packs to Lure Children

Devika CHADHA, Ajay PILANKAR
Salaam Bombay Foundation
Context: Attractive areca nut packaging lures young customers causing pre-cancerous conditions claiming many young lives.
Aims: Understand packaging and labeling of areca nut brands and their similarities with those of other products. Materials and Methods: Packaging of
areca nut brands used commonly by children in Mumbai was analyzed for brand name, visual imagery, and product information. They were also compared to
packaging of gutkha and paan masala, which are banned in many Indian states. Results: Two of three areca nut packaging had bright, eye-catching, and attractive
background colors (yellow, red, and blue). One of these two brands was known as “Mogali” – a popular Indian cartoon character. This brand not only used nameof character, but also picture and color scheme of the cartoon series. Second brand was named “Ritik”, after a popular Indian movie actor - “Hrithik Roshan”,
who shot to fame with his dancing and acting skills. One of the packaging of “Ritik” brand of areca nut showed picture of young boy dressed similar to what actor“Hrithik” did in his first movie, which was successful and catapult the actor to fame. Third packaging (“Milan” supari) unlike previous two packaging was notcolorful and openly stated areca nut as “proprietary food product”. A feature common to all areca nut packaging was they were marketed as providing pleasantflavor (“Mogali” – Kesar Scented, “Ritik” - Mint Supari and Kesar Scent Supari, and “Milan” - “Classic Sugandhi Supari” which means classic scented flavored
areca nut). The pouches were also compared to other popular products viz. gutkha and paan masala, noting distinct similarities. Both areca nut and, gutkha andpaan masala pouches were colorful and attractive. Areca nut brands used cartoon characters and movie personalities to attract attention similar to what gutkha
packets did through their use of names and pictures of movie stars and popular holiday destinations in India symbolizing a feeling of relaxation which gutkha
consumption could simulate (“Munna Bhai” gutkha, “Goa” gutkha, “Shimla” gutkha). Areca nut and paan masala packaging were similar in that they projected
to provide sweet and delicious flavor to its consumer. An observation that needs special mention is that areca nut products seem to be targeted towards children
by introducing cartoon character and child dressed as movie actor. Conclusion: Even though gutkha and paan masala are banned in many Indian states, otherequally harmful products are packaged, labeled, and marketed similar to banned products, targeting children

P-S16-01

TPPA and Tobacco Control: Three Major Threats for ASEAN Countries

Robert STUMBERG, Matthew PORTERFIELD, Deborah K. SY
Georgetown University
Background: Eight countries of the APEC are negotiating a so-called 21st century free trade agreement (FTA) with the United States. Six of the eight countries,
Australia, New Zealand, Vietnam, Singapore, Malaysia and Brunei, are located in the Asia Pacific while the other two, Chile and Peru, are located in Latin
America. In the latest, fifteenth round in December 2012, two countries from North America, Canada and Mexico have joined the negotiations. From the startof its negotiations in March 2010, the TPP is being designed to attract more participants from the APEC. As initially proposed, the Trans-Pacific Partnership
Agreement (TPPA) would give the same trade benefits and legal protections to tobacco products, services and investment that it gives to any other sector.
Tobacco, however, is the only legally available consumer product that kills people when used as directed. Method: This paper demonstrates how specificprovisions in these chapters would create obstacles to the FCTC parties’ commitment to accelerate implementation of the FCTC and illustrates the potential
impact by drawing examples from existing tobacco control measures in a few ASEAN countries. Results : Based on available drafts and recent treaty practices,
this report summarizes three major threats that specific TPPA chapters pose to tobacco control, namely, investments, regulatory coherence, and services. The
investment chapter permits foreign investors to bring claims against governments before international tribunals based on regulatory measures that decrease theprofitability of their investments. These investment rules provide foreign investors — including tobacco companies — with both substantive and proceduralrights that threaten tobacco regulations Trade in services affects almost every sector of the economy, including the advertising, distribution and sale of cigarettes.
Although some parties to the TPPA have already made commitments to adhere to trade rules that limit regulation of services, the TPPA is expected to significantly
expand the scope of commitments for all of the negotiating countries The draft Regulatory Coherence Chapter of the TPPA creates two coordinating bodies
to provide industry stakeholders with access to decision-making. This would contradict obligations under the Framework Convention on Tobacco Control(FCTC) for countries to protect their regulatory process from influence by the tobacco industry. Similarly, the RC Chapter promotes cost/benefit analysis thataims to minimize regulations and evaluate the “distributional impact” on stakeholder industries. This also contradicts an FCTC obligation to not balance the“irreconcilable conflict between the tobacco industry’s interests and public health.” Finally, the RC Chapter’s method for Regulatory Impact Assessment (RIA)
could produce evidence that investors and governments could use in a different context to challenge tobacco control measures. Conclusion: The development
and implementation of existing tobacco control measures in certain ASEAN countries would be adversely affected by the TPPA provisions. Trade negotiators
should consider the various means of excluding tobacco control measures from the coverage of the TPPA.

203

P-S16-02

International Trade Law, Plain Packaging and Tobacco Industry Political Activity: The Trans-Pacific Partnership
Agreement

Gary J. FOOKS1, Jeff COLLIN2, Anna B. GILMORE1
University of Bath1, University of Edinburgh2
The tobacco industry has a long history of using international trade agreements to force open new markets in low and middle income countries. Recent evidence
suggests that major tobacco companies are increasingly turning to trade and investment agreements to challenge measures aimed at reducing tobacco use. Current
industry efforts in this area centre on policies designed to reduce the effects of pack branding on consumer demand (such as generic packaging and large pictorial
warnings) and take three broad forms: support for national governments’ complaints to the World Trade Organisation (WTO); direct legal action against national
governments using Investor-State Dispute Resolution (ISDR) under trade and investment agreements; and lobbying national governments to shape the terms of
new trade treaties so as to extend the coverage of ISDR and limit governments’ capacity to introduce legislation promoting health.
This paper focuses on the last of these and specifically on Philip Morris International’s (PMI) efforts to influence the Trans-Pacific Partnership Agreement(TPPA), a major trade and investment agreement which may eventually cover 40 per cent of the world’s population. In particular, it focuses on how these efforts
might enhance the power of tobacco companies to challenge the introduction of plain packaging and other innovative tobacco control measures. Specifically,
the paper discusses the implications for public health regulation of Philip Morris International’s interest in using the TPPA to: shape the bureaucratic structuresand decision-making processes of business regulation at the national level; introduce a higher standard of protection for trademarks and patents than is currently
provided under the Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS); and expand the coverage of Investor-State Dispute Resolution(ISDR) which empowers corporations to litigate directly against governments where they are deemed to be in breach of investment agreements. The large numberof countries involved in the TPPA underlines the risk it presents to the development of tobacco regulation globally.

P-S16-03

Illicit Cigarette and Potential Revenue Loss in Indonesia

Abdillah AHSAN, Nurhadi WIYONO, Diahhadi SETYONALURI
University of Indonesia
Background : There are two types of illicit cigarette in Indonesia: smuggled cigarettes and illegal domestically produced and marketed cigarettes. Unlike inmany countries in Europe where concern is focused on smuggled cigarettes, the policy makers in Indonesia are more concerned about illegal domestic cigarette
production. This situation exists because 90% of smokers smoke kretek, a tobacco and clove cigarette produced mostly in Indonesia. This research will not only
focus on smuggled cigarettes but also on illegal domestic cigarettes as defined by the Indonesian Excise and Custom Office.
Objectives : To determine the magnitude and consequences of the illegal cigarette domestic production and trade in Indonesia.
Method : We calculate the discrepancy between, domestic consumption less domestic legal production, and exports minus imports of cigarettes. If there is no
illicit trade there should be no discrepancy between the two values.
Result : for 2002-2004, we estimate that there was massive increased production of illegal domestic cigarettes, together with possibly some net smuggling in.
This amounted to 22-25 billion sticks per year, or 11-13% of total cigarette consumption. We estimate that the loss of government revenue from these illicit
cigarettes ranged between Rp 2.7 Trillion and Rp 3.5 trillion(US$ 327-409 million) for 2002-2004, or between 9% and 13% of total tobacco excise revenue. In
order to reduce the smuggling and illegal cigarettes production, the government should increase resources to enforce the Act No. 39 Year 2007 about the excise
system in Indonesia, especially related to illicit cigarette production.

P-S16-04

Estimating the Scope of Illicit Tobacco Trade: Southeast Asia Case Study

Hana ROSS , Michal STOKLOSA1, Ryan DENNISTON2, Joy TOWNSEND3, Anthony D. SO2
American Cancer Society1, Duke University2, London School of Hygiene and Tropical Medicine3
1

Objectives
To contrast two different low-cost, quantitative methods recommended by the World Bank to estimate the magnitude of illicit cigarette trade, and to assess theirapplicability for a low-income country setting.
Methods
Researchers from seven Southeast Asian countries (Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand, and Vietnam) applied two methods to estimate
the size of illicit cigarette trade. The first method compares mirrored records of cigarette exports and imports between trade partners. The second method
compares estimates of population-level cigarette consumption to official tax-paid sales data. The researchers adapted these methods to fit the quality andavailability of data, as well as differences in record keeping across countries.
Results
Given the weaknesses of the methods, the availability and the quality of the data, and inconsistent results, no valid conclusions about the magnitude of cigarette
tax avoidance and evasion could be drawn.
Conclusions
The estimates of the size of the illicit cigarette market are highly volatile and sensitive to baseline assumptions. Although using secondary data to estimate illicit
tobacco trade, as described in the World Bank Toolkit, is relatively affordable, additional data collection or alternative methods are necessary to provide morereliable estimates of cigarette tax avoidance/evasion.
ACKNOWLEDGEMENTS:
This project received support from the NIH Fogarty International Center (Grant Number R01TW007924), awarded to Duke University's Program on Global
Health and Technology Access in collaboration with the Southeast Asian Tobacco Control Alliance and the American Cancer Society. The content is solely the
responsibility of the authors and does not necessarily represent the official views of the Fogarty International Center or the National Institutes of Health.

204

P-S16-05

Strategies for Moving to the Elimination of Smoking

Ron BORLANDThe Cancer Council Victoria
This paper sketches out options and related frameworks to facilitate the elimination, as far as possible, of the harms associated with tobacco use. This challenge
can usefully be considered as a two stage process: first, the effective elimination of smoking cigarettes and other high-harm forms of tobacco use, and second,tackling the residual problem associated with addictive use of low-harm nicotine products. This framework has the capacity to reunite the harm-reduction andabolitionist wings of the tobacco control movement. Theory suggests that the first task will be easier if there are alternative nicotine delivery systems available tosubstitute for the high-harm forms. The more attractive to smokers the low harm forms the better, but the greater the risk of attracting non-smokers to use. This
could be done with or without concurrent attempt to reduce the appeal of current cigarettes, but the less attractive the cigarettes, the more likely the transition
will be effective. The biggest challenges associated with achieving such goals are doing so while keeping any illicit market under control. Co-ordination of these
possibilities requires a regulatory apparatus. Depending on the rate at which the shift to low-harm potential products occurs, regulation will be easier to pursue
if control of tobacco marketing is removed from interests motivated to slow or undermine the process. Further, depending on the consensus on the extent of theresidual harm, it may also be desirable to constrain the low-harm market to not-for-profit marketing. Product regulation should be easier and more rapid if themarketers of products are not in intrinsically antagonistic relationships with regulators. This approach is contrasted with the main alternative of a regulatory
apparatus like the US FDA which can work but involves the inevitable antagonistic relationships that are already becoming apparent.
Funding: None. Conflicts of interest: None

P-S17-01

Smoke-free Sports to Advocate for a Nationwide Smoke-free Legislation

Kong MOM, Yibee HUANG
Cambodia Movement for Health1, Taiwan International Medical Alliance2
Indoor smoking is banned at educational facilities, health facilities, Buddhist temples, and some government workplaces. But smoking at restaurants, hotels,
public transportation means and other crowded public places is still allowed. Developing a binding nationwide legislation in order to ban smoking an all
workplaces and public places is on the process. Advocacy needed to get the smoke-free legislation passed.
The first nationwide smoke-free sports were hosted by the Department of Physical Education and Sport (DPS) in 2012. The overall objectives of the event were to
inform athlete, people engage in sports and general public that sports and smoking cannot mix. Prior to the event, the smoke-free theme was promoted via letters
informing entities and individuals who were interested in joining the sports, as well as through the press conference. 25 teams of football, 20 teams of volleyball,
13 teams of basketball, and 43 athletic teams joint the event, and the it was managed by approximately 400 managers, trainers and members of organizing
committees. The teams for the first volleyball match were CO tested to show to youth that good players do not smoke. Approximately 10,000 audiences were at
the event. Banners carrying smoke-free sports and “No-Smoking” signs were at all sport venues for the 15 days competition to alert people about the smoke-free
event and to ban smoking in these places. Organizing team members enforced the ban. The event was on at least 27 news of television, 27 radio news features,
25 newspaper articles and 20 webpage.
The after event follow up shown that there was much less cigarette butts found in the campuses compared to the previous years events. Majority people including
athletes, sporting entities and audiences supported the initiative and encouraged the DPS to have sport events smoke-free next year.
We hope that the smoke-free theme in sports becomes norm and next sport events will be smoke-free. The event also shown strong support from sport sector
toward the smoke-free legislation passage.

P-S17-02

Tobacco Industry Opposed Total Ban of Tobacco Advertising, Promotion and SponsorshipKong MOM
Cambodia Movement for HealthTobacco industry, particularly BAT Cambodia started to fight total ban of tobacco advertising, promotion and sponsorship (TAPS), when Cambodia established,in early 2010, the Working Group (WG) to draft a Sub-Decree on TAP Ban to meet the obligations under the FCTC’s Article 13.
BAT Cambodia opposed a complete total advertising ban, and called for regulation restricting mass media tobacco advertising, Mr. Kun Lim, BAT’s spokesman
was quoted by the Phnom Penh Post dated April 2, 2010. To get its so called restriction instead of total ban, tobacco industry put a lot of efforts to weaken the draft
sub-decree on TAPS ban by lobbying several government institutes and individuals to give tobacco companies some spaces free of ban, including points of sale.
BAT praised those government officials for their commitment to listen and to ensure that no burdens were placed on businesses. But because the WG comprisedof strong local advocates, the pro-tobacco industry members could not do much and the draft sub-decree was comprehensive.
In addition, on the way it was submitted to the Council of Ministers for approval, tobacco industry, through its pro-tobacco industry members, inserted a weakerversion attempting to replace the comprehensive one. The local tobacco control advocates were vigilant and immediately were able to get support from higher
policy makers to successfully withdraw the weaker version. The weaker version reflected clearly what tobacco industry fought for, that was not a comprehensive
ban, but just restriction on advertising, including no ban on promotion and points of sale.
Finally, the comprehensive sub-decree was successfully approved by the government in February 2011, banning all forms of TAPS including at points of sale.
Tobacco industry did not end their efforts, they misinterpreted the sub-decree by changing their direct advertising billboards to indirect one, and continuing
advertising at points of sale.
The letters of warning of the Ministry of Health forced tobacco companies to remove the indirect advertising billboards. The Phnom Penh Municipality
confiscated TAPS materials, including posters, umbrellas, and cigarette selling stands, at points of sale.
BAT sent its group of lawyers to misled key people in-charge of tobacco control and media.
Efforts to enforce TAPS ban have been continued and tobacco industry are trying their best to look for loopholes to manipulate the sub-decree.

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P-S17-03

Current Situation of Smoking Environment and Measures against Passive Smoking in Golf Courses in the Kyushu
District

Tetsuro KITA1, Muneyoshi TAKAHASHI2, Takeo HASHIGUCHI3, Shin YOSHIHARA4
Musashino Art University1, Kyorin University2, Teikyo University of Science3, St.Marianna University4[Introduction]：Golf is one of sports popular also as lifelong sports in Japan, while it can be said to be a rare sport of which players have been nearly allowed
to smoke and drink liquor during play. The objective of this study was to investigate actual situation relating to cigarette in golf courses in the Kyushu district
and to obtain basic resources on the smoking environment and the measures against passive smoking in golf courses in Japan.
[Methods]：In this study,
a survey was performed in 254 golf courses in Kyushu district in Japan. The survey was performed from June 1 to July 31, 2012 by mailing questionnaires.
Responses were obtained from 61 golf clubs with a recovery rate of 24.0%.
[Results and Discussion]：As places where smoking was allowed in thecourse or in a round, in the results, “tee”(88.5%), “inside of golf cart”(77.0%), “inside and neighborhood of teahouse and restroom”(62.3%), “any place in thecourse”(19.7) and “others”(8.2%) were mentioned in order of decreasing prevalence. Responses as “others” with free description included those stating that“ban on smoking is not laid.” Answers to a question about smoking in the clubhouse were “total ban on smoking”(21.3%), “smoking rooms (rooms withpartitions preventing diffusion of smoke to outside) are provided”(3.3%), “smoking areas are provided within doors”(49.2%), “smoking areas are provided in
outdoor locations”(26.5%), “smoking is totally available”(23.0%), and “others”(3.3%). Answers to a question as to whether they thought that regulation withregard to the smoking environment in the golf course would make an adverse influence such as decrease in the number of the visitors on the business relating
to the golf course were “definitely think so”(11.5%), “think so”(16.4%), “no opinion”(23.0%), “don’t think so”(24.6%), and “don’t think so at all”(21.3%).
Answers to a question as to what elements are required in the future in order for the golf course industry to promote measures with regard to smoking were“ordinance or legal regulation prohibiting passive smoking”(13.6%), “provision by media of information concerning smoking and ban on smoking”(26.1%),“provision of information from the state, NPO, etc.”(1.8%), “subsidies from the state”(5.4%), “needs from customers for ban on smoking ”(18.9%), “employees’
understanding”(1.8%), “ban on smoking throughout Japan”(3.6%), “ban on smoking throughout the world”(2.7), “trend in the industry and the trade”(26.1%),
and “others”(0.0). We hope to still continue the investigation so that we can make some sort of proposals or suggestions relating to smoking to the golf courses
and golfers in Japan.

P-S17-04

A Survey of Tobacco Advertisements in Magazines Published during 2009 in Japan

Isao WATANABE1, Masako SHIGETA1, Satomi KAN1, Naomi MIKAMOTO1, Kaoru INOUE1,2, Daisuke MATSUI1, Tadaaki MORI3, Etsuko OZAKI1,
Nagato KURIYAMA1, Yoshiyuki WATANABE1
Kyoto Prefectural University of Medicine1, Kyoto Tachibana University2, Kyoto Association for Tobacco Control3[Backgrounds] Japan does not have any laws banning tobacco advertisements. The tobacco industries have refrained voluntarily from producing direct tobacco
advertisements on TV since 1998 and in magazines for children since 2002. But they have been advertising tobacco in popular and major magazines regularly.
The earnings from these advertisements have editorial potential to bias their stance on tobacco issues.
[Objective] In order to review of tobacco advertisements in Japan, we aimed to collect all direct advertisements of tobacco in magazines and described them
multilaterally.
[Methods] We investigated tobacco direct advertisements in magazines which were purchased by a public library in 2009 and estimated earnings of publishers.
We also analogized the strategies to promote tobacco sales by analyzing their slogans and assortment of the prizes for customers.
[Results] All of the magazines targeting young men (3/3) and half of general interests’ magazines (11/20) had tobacco advertisements. There were no advertisements
in magazines targeting women. The advertising pages were 284, and the campaigns were 155 (Japan Tobacco; 70, Phillip Morris; 56, and BAT; 29). One third of
the campaigns offered very expensive prizes, such as cars (Jaguar), a trip to Milano, and so on. Estimation of total earnings of publishers was 459 million Yen.
The biggest publisher “Bungeishunjyu-sha” which publishes Japanese leaders’ opinions earned the most at 131 million Yen. Most slogans targeted young people.
“Menthol”, “light”, “smooth”, “one mg” and “new” were often used. There were 4 advertisements for young women even in magazines for men.
[Conclusion] Tobacco industries tactically promoted marketing for young people. And tobacco industries pay big money for these advertisements. The stanceof mass media might be influenced by the advertisement expenditure. To better distribute of scientific information about tobacco to the general public, thesestructures should be monitored sufficiently and eliminated as soon as possible.

P-S17-06

Whose Influence Counts: Tobacco Industry or Tobacco Control Groups? Tobacco Industry Interference in Bangladesh

Taifur RAHMAN1, Monowar HOSSEIN2
Campaign for Tobacco-Free Kids1, PROGGA2
The interference of tobacco industry in tobacco control policy formulation is common across the world. However, the nature and tactics of interference differ
across contexts. In Bangladesh, tobacco industry’s tactics in policy interference have their own characteristics although the overall strategies have been the sameas elsewhere in the world. The tobacco industry in Bangladesh has been particularly aggressive in influencing the two major policy areas that they are mostconcerned with: (one) comprehensive tobacco control legislation and (two) tobacco taxation.
Bangladesh is one of the earliest Parties to the Framework Convention on Tobacco Control (FCTC) although the first tobacco control law that the country enacted
fell short of FCTC requirements in a number of ways. Consequently, the tobacco control groups have been advocating and lobbying for a more FCTC-compliant
law and have been able to move the process to a great extent. When the process of amending the tobacco control law made notable progress and was at a mature
stage, the tobacco industry jumped in with their various tactics of influencing the law making process.
Similarly, the tobacco industry has always been investing a lot in the Ministry of Finance and the National Board of Revenue (NBR) to make sure that effective
taxation is not adopted in the national budget of the country. Thus, every year before the budget, the industry comes up with wide range of tactics to influence
the budget and retain the taxation in their favor.
The tactics that the tobacco industry use here include everything that they are known for across the world. But their interference here is very much context
specific as reflected in numerous examples of their activities that they have been doing in recent time. Clever use of corporate social responsibilities (CSR) havealways been one of their core strategies. The industry has been using CSR in Bangladesh not only to promote their products, but more importantly to create
sympathy among policy makers for preventing effective tobacco control policies.
The paper will tell the recent stories of tobacco industry interference in Bangladesh to undermine strong tobacco control policies that the tobacco control groups
have been fighting for. The fight between the tobacco control groups and the tobacco industry for and against strong tobacco control legislation and tax will
constitute the central theme of the paper.

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P-S17-07

A Study on Types and Constituents of Tobacco Products Used in Myanmar

Aung TUN, Su Mon MYAT, Thuya AUNG, Phyu The HAN, Tun MYINT
Ministry of HealthObjectives -The study aims to collect information on types and constituents of tobacco products used in Myanmar
Methods -The study conducted during November 2011 by the School health project and National Tobacco Control Program of the Department of Health,
Ministry of Health with the support of World Health Organization. (20) trained surveyors from 14 State/Region School health Teams conducted data collectionin their States and Regions. Due to lack of facilities, laboratory analysis of tobacco products was not conducted although certain elements of a few tobacco
products had been analyzed.
Results - (a)Cigarettes: Cigarettes commonly used in all parts of the country are mainly of domestic products such as Red Ruby, Premium Gold, Blue Diamond,
V and Duya . Marlboro, 555, Mild Seven and London are still popular multinational brands.
(b)Cheroots: Cheroots are the most commonly used smoking tobacco products in Myanmar. Popular brands differed among States and Regions. Popular brandsof Cheroots include Jothein, 44444Kyene and Shwe Hnin Si.
©Cigars and Pipes- Now, Cigars and Pipes are not popular in all parts of the country. It was practiced only among older men.
(d)Smokeless Tobacco Products(1) Betal preparation with tobacco- It is being practiced widely in all parts of the country. Varieties of tobacco added into the betal preparation include(1.1)Myanmar Hsay (Myanmar Tobacco) (1.2)Hsey Paung or Hnut Hsey (Tobacco leaves and stem treated with alcohol and honey)(1.3)Hsey Hmwe includes Popular brands of treated tobacco imported from India (eg-Signal,45,92 and Parijet) and Popular Domestic brands of treated
tobacco (eg. Bayinma, Top and Shwe Bamar)
Popular Cigarettes(2) Raw Tobacco -Chewing of Raw tobacco is practiced in rural areas, especially in hilly tribes.
Conclusion - This study depicts updated information relating to types and constituents of tobacco products used in Myanmar
for better understanding of the nature of tobacco use in Myanmar for effective implementation of comprehensive tobacco
control programs. More in-depth studies should be carried out including laboratory analysis, physiological investigations
Betal preparation with tobacco
on lung and cardiac functions, cohort studies and case-control studies to find out the health effects of using these products.

P-S17-08

Activities with Non-governmental Efforts in Korea Tobacco Control Policy

Eun Ji KIM, Hong Gwan SEO
Korean Association on Smoking or Health
Since first introduction of tobacco into Korea around 1600, many Koreans smoked tobacco. In 1988, Korea opened its market to foreign tobacco companies. At
that time, adult male smoking rate was nearly 80% and people could smoke any places in Korea. But the smoking prevalence has rapidly decreased to 48.3%
in 2010 and smoke free places increased 26 places including public facilities, educational facilities, medical organizations, public transportations and large
restaurants. According to newly revised Health Promotion Law, all restaurants are designated as a smoke-free place from 2015. This astonishing results from theefforts of Korean government as well as non-government organizations like KASH, Korean Association on Smoking or Health. This report discusses the roleof the Korean government, NGOs as well as the KASH whose mission was to improve public health and contribute to the nation's development by reducing thehealth hazards of smoking through conducting nationwide anti-smoking campaign. KASH has the longest history among civic organizations specializing in antismoking movements. KASH has been the driver of anti-smoking campaigns, the provider of information on smoking and the proposer of anti-smoking policies.

P-S17-09

Tobacco Control Policy of Chinese TV Drama and the Research on Exposure to Tobacco Lens

Chao SUO
Chinese Association on Tobacco Control
Objective: To understand the situation with tobacco in popular domestic TV drama, explore ways to improve tobacco control policies in order to effectively
reduce the number of tobacco shots and the time length of them. Methods: According to the movie box ranking and drama's ratings announced on the networkin the year, select 40 films and 30 television series with high ranking, rating and great public influence for the survey. Develop a unified definition for smoking
scenes, purchase unified timers, gather the statistics of occurrences of tobacco, duration, and place. Results: "The screenplay (outline) for the record, effective
implementation of Films Provisions " has been implemented effectively, the implementation of "the SARFT drama Management Division strict control ofsmoking scenes in the drama" and "the General Office of the SARFT for strict control of the film, implementation of the smoking lens of the notice" in thedrama is not so obvious. Conclusion: TV drama management department should clearly define the tobacco control policy the number of tobacco lens in the TV
drama and the highest standards of the time length; enhance the guidance and educational function of the movies and television, promote the idea that smoking
is harmful to health, strengthen the tobacco control awareness of the film and television workers, and create a healthy working atmosphere and environment.
Keywords: tobacco scenes；film and television；tobacco control policy207

P-S18-01

The Relationship between Public Assistance and Smoking in a Psychiatric Clinic

Yohsuke USUI1, Sawako SAKATANI2, Noriko HIRAGA3, Kouki OKAMOTO4, Masaki IZUMI2
Honda Motor Co.1,Tokyo Musashino Hospital2, Kinen-kobo3, Lawyer4
Key words：public assistance，psychiatric patient，smoking，nicotine dependence
Objective
At the first author’s psychiatric clinic，we have surveyed the relationship between public assistance and smoking．From our findings we propose that the social
problem of smoking is related to public assistance．
Methods
We have surveyed whether a patient is a smoker or non-smoker，and whether he or she is getting public assistance or not．The sample is taken from thefirst author’s outpatient clinic (54 men and 84 women in Musashino Hospital，Tokyo between November 2009 and February 2010． We have examined therelationship between smoking and receiving public assistance by a χ2－test．We compared psychotic disease with the rates of smoking and the rates of receiving
public assistance．
Results
Patients who are receiving public assistance have higher rates of smoking by percentage than those who don't receive public assistance． The rate of smoking
patients who are receiving public assistance is 73.1%．The rate of smoking patients who don't receive public assistance is 16.1%．There is a relationshipbetween smoking and receiving public assistance（p<0.001）．
Discussion
The source of public assistance money is tax revenue．Public assistance is made possible by Article 25 of the Constitution of Japan which states “All people
have the right to be at least healthy and living a cultural life．Public assistance must be used as a last resort for poor persons who are in serious need”．In
reality，public assistance is used for smokers． We think there should be a review of public assistance．
Conclusions
We should help the poor and socially disadvantaged people quit smoking，not give them public assistance to continue smoking．

P-S18-02

Smoking Prevalence and Behaviours amongst a Longitudinal Cohort of Pacific Islands Fathers in New Zealand

El-Shadan TAUTOLOAUT University
Background: Pacific men’s health, and particularly the health of Pacific fathers, is a significant health priority which in recent years has become a largely
neglected yet important area for health researchers and policy makers in New Zealand to consider. Moreover, it is being increasingly recognised that fathers canhave a significant impact on the development and well-being of their children; both positively and negatively.
This research study examines the smoking prevalence and behaviours amongst a longitudinal cohort of Pacific Island fathers resident in New Zealand. The
findings are helpful in providing some insight into the smoking practices of these fathers, and how these behaviours may support and affect the development of
their children.
Methods: Participants were fathers of Pacific ethnicity enrolled in the Pacific Islands Families (PIF) Study, a longitudinal study following 1398 Pacific families
since the year 2000. An investigation of data collected from approximately 800 fathers at the 11-year measurement point of the PIF study examined variables
measuring general health status, health-seeking behaviours, and potentially harmful behaviours such as smoking status and alcohol consumption.
Results: The majority of fathers within the study reported good overall health status and behaviour. However, approximately 40% of fathers classified themselves
as current smokers, and of the 61% of fathers that classified themselves as current alcohol drinkers, over 1/3 consumed more than ten alcoholic drinks during atypical drinking occasion. Nevertheless, of those fathers that were smokers, 80% indicated that they were interested in quitting, and 75% reported that the NZ
tobacco tax increases between 2010-2012 had caused them to reduce their smoking.
Conclusions: Although most fathers in this study possess positive health attributes, values, and behaviours, a concerning number of fathers exhibited poor
health status and harmful patterns of smoking and alcohol consumption. Strategies targeted at alleviating some of these issues are vital to supporting the positive
development of these fathers, and consequently their children and families.

P-Y1-01

The Result of the Smoking Prevention Education in a University

Mieko TANAKA
Hokkaido Pharmaceutical University[Purpose] In order to propagate the idea of “pharmacists who do not smoke,” education for promoting no-smoking as well as an anti-smoking campaign targeted
at students of Hokkaido Pharmaceutical University School of Pharmacy has been underway since 2003. We will report on the transition of the smoking rate from2003 to 2012 and the contents of our activities.
[Method] Questionnaire surveys were conducted to students of Hokkaido Pharmaceutical University, (which has adopted 6-year education system since 2006).
The students answered the questionnaires unsigned. They were asked about "smoking habits" and "lifestyle".
[Results and Consideration]: Hokkaido Pharmaceutical University have established "anti-smoking task force" in 2003. Its activities include no-smoking
education and a wide range of anti-smoking promotional campaigns, such as putting up anti-smoking posters made by Japan Pharmaceutical Association andenlarged copies of the newest articles on tobacco on the university bulletin board and setting up a no-smoking support room. When we started smoking prevention
education, there were not a few of smoking staff, who were critical of the activities of the task force or could not try to quit smoking. However, the smoking rateof personnel of Hokkaido Pharmaceutical University has steadily fallen from 17.5% in 2003 to 2.4% in 2012, which clearly shows the effectiveness of "smoking
prevention education". Looking at each grade, every year, as the students are higher in their grades, the smoking rate gets higher. However, since the 6-year
education system started, the smoking rate for students of fifth and sixth grades, who get long-term on-site training in hospitals and community pharmacies, tends
to drop. One of the reasons for this is that hospitals and pharmacies are completely no-smoking facilities. In addition, the higher awareness as a professional
healthcare provider that the students acquire during their long on-site training must be one of the factors.
The rate of conversion from smokers to no-smokers has risen greatly from 19.4% in 2003 to 67.6% in 2012, which clearly shows the effectiveness of the antismoking education which we have been providing over ten years. However, it is necessary to provide health education as well while we continue to promote
educational activities at early stage after students enter the university.

208

P-Y1-02

Smoking Awareness in the Higher Grades of Elementary School and Effectiveness of a Smoking Prevention Class-Comparison Immediately after and One Year after the Class-

Tomoko KAWABATA1, Hiromi MORI2The University of Shiga Prefecture1, Omihachinan Community Medical Center2
Purpose:The purpose of this study was to clarify the smoking awareness of children in the higher grades of elementary school and to compare the effect of a smoking
prevention class at the time of its completion and after one year.
Methods:
The subjects were 80 fifth-grade students in a public elementary school in one prefecture of Japan in 2012 who took a smoking prevention class. A survey was
conducted with a self-completed questionnaire before, immediately after, and one year after the smoking prevention class. The questionnaire consisted of items
on gender, whether or not the respondent has a smoker in the family, and the Kano Test for Social Nicotine Dependence (KTSND; elementary school version),
which judges psychological dependence on smoking. A one-way analysis of variance with repetitive measures was conducted using differences in KTSND scorewith respect to the effectiveness of the class. Differences were statistically significant at a significance level of p<0.05. This study was approved by the ethicalreview boards of Hospital A and University A.
Results:
Questionnaires were collected from 71 of the 80 students (valid response rate, 88.7%), of whom 43.7% were boys and 56.3% were girls. The percentage of thosewith a smoker around them was 53.5%. The total KTSND score was 6.24 (±4.803) before the class, 3.59 (±3.635) immediately after the class, and 5.99 (±4.027)
one year after the class. Comparison revealed that the total score was significantly lower immediately after the class than before (p<0.001), but no significant
difference was seen in total scores before and one year after the class.
Discussion:
The smoking prevention class in this study led to significantly lower total KTSND score immediately after the class, and an effect is thought to have beenachieved. After one year, however, the total score was about the same as that before the class, suggesting the need for continuous, repeated learning, similar to
the findings of previous studies.

P-Y1-03

Smoking Habits among Japanese Adolescents: A Nationwide Representative Survey (1996 - 2010)

Osamu ITANI1, Yoshitaka KANEITA2, Maki IKEDA1, Shuji KONDO1, Ryuichiro YAMAMOTO3, Kenji SUZUKI4, Susumu HIGUCHI5, Hideyuki KANDA6,
Yoneatsu OSAKI7, Takashi OHIDA1
Nihon University School of Medicine1, Oita University2, Graduate School of Education, Joetsu University of Education3, Suzuki Mental Clinic4, National
Institute on Alcoholism, Kurihama National Hospital5, Yokohama City University6, Tottori University7
Objective: The main objective of this study was to clarify smoking habits among Japanese adolescents. Methods: We previously conducted four cross-sectional
nationwide surveys (1996, 2000, 2004, and 2008) of smoking habits among Japanese adolescents. The 2010 study was the fifth such survey. For that study, amongthe 10,785 junior high schools and 4,991 senior high schools registered in Japan in September 2010, 131 junior high schools (selection rate: 1.2%) and 113 seniorhigh schools (selection rate: 2.3%) were sampled. We used a stratified, single-stage cluster sampling
method in which we divided Japan into regional blocks and randomly selected schools from eachblock. The investigation employed a self-completed questionnaire that was distributed to all students
at each candidate school. Results: In the 2010 study, a total of 99,416 adolescents responded. The
overall response rate was 63.7%, and 98,411 questionnaires were subjected to analysis. This revealed
the following results: Any experience of smoking: Junior high school males, 10.2%; Senior high school
males, 19.5%; Junior high school females, 7.2%; Senior high school females, 12.5%. Smoking once amonth: Junior high school males, 2.5%; Senior high school males, 7.1%; Junior high school females,
1.5%; Senior high school females, 3.5%. Smoking every day: Jenior high school males, 0.7%; Seniorhigh school males, 3.5%; Junior high school females, 0.3%; Senior high school females, 1.4%. Whenthe transition of smoking habits between 1996 and 2010 was examined, a year-by-year decrease in
the prevalence of smoking was observed. Conclusion: The prevalence of smoking among Japaneseadolescents has been decreasing in the last few years, suggesting that smoking control measures aimed
at the young have been working effectively in Japan. It will be necessary to continue this investigation,and to closely monitor the changes in the prevalence of smoking among adolescents.

P-Y1-04

Survey of High School Teachers about Tobacco

Tatsuhiro KOMOTO1, Yuji SAKURABA1, Takuya SHIDARA1, Emi KISARA2, Keiko KAWASHIMA1, Kenichi KOMATSU1, Mieko TANAKA1
Hokkaido Pharmaceutical University1, Jozankei Hospital2[Purpose]According to JT, in fiscal year 2011, the smoking rate of Japan is 21.7%, which is highest in the developed nations. One of the reasons for this is because
the “no-smoking” education for young people in Japan has not been enough. In order to research on the young people’s smoking habits, a questionnaire survey
on tobacco was conducted to high school teachers who are supposed to educate students not to smoke.
[Method]The time period for the questionnaire was from October 25, 2012 to November 30, 2012. The questionnaire was conducted to the personnel working
in seven high schools in Hokkaido, Japan. The questionnaires were left with the respondents to be picked up at a later date. The respondents answered thequestionnaires unsigned. 231 men (73.6%) and 83 women (26.4%) answered to the questionnaires. Of the 314 respondents, 279 (88.9%) were teachers and 35(11.1%) were clerks. The response rate was 96.6%.
[Results and Consideration]23.2% of the personnel in the 7 high schools (Hokkaido, Japan) were smokers. (The rate was 22.6% for teachers and 28.6% forclerks). This number is higher than the smoking rate of 21.7% of general Japanese people in 2011. The fact that the smoking rate for teachers is not zero meansthat smoking teachers tell students not to smoke and teach them about health hazard caused by smoking, which is not convincing. The higher smoking rate ofteachers can influence the smoking rate of students. This means that it is urgent for teachers to attend non-smoking seminars and other non-smoking campaigns.
It is also important to standardize the contents of anti-smoking education all over Japan in order to raise the general awareness for anti-smoking higher than it istoday. In addition, Japan should keep up with the global non-smoking movement so that we will enjoy a healthier nation.

209

P-Y1-05

Gender and Smoking among Adolescents in Thailand: Findings from Wave 5 ITC-SEA (Thailand) Surveys

Buppha SIRIRASSAMEE1, Tawima SIRIRASSAMEE2, Ron BORLAND3, Geoffrey T. FONG4, David HAMMOND4
Institute for Population and Social Research1, Srinakarinwirot University2, The Cancer Council Victoria3, University of Waterloo4
Background : Smoking among male and female smokers are more or less the same and sometimes female smokes more than male in some countries especiallyin Europe and America. It is interesting to know if gender makes any differences in terms of smoking among male and female adolescents in Thailand.
Objective : 1. To explore the smoking prevalence among male and female adolescents in Thailand over period of 5 years.
2. To analyze the differences between male and female adolescents in terms of belief, knowledge and opinion on smoking.
Methods : A part of 5 waves of the International Tobacco Control Policy Evaluation Surveys Southeast Asia (Thailand) (ITC-SEA) Project, undertaken during
2005 - 2011. Respondents consisted of 1,000, 962, 1,096, 958 and 961 adolescents at Wave 1, 2, 3, 4 and 5 respectively, aged between 13 – 22 years old.
Participants were recruited using stratified multistage sampling from 5 regions of Thailand. The sample was designed to be national representative and regional
level which covered both rural and urban areas in Thailand. Respondents were asked to complete self-administered questionnaire. Descriptive statistics was
employed to explore the smoking prevalence among male and female adolescents in Thailand over period of 5 years. The wave 5 survey data was analyzed to
study the differences between male and female adolescents in terms of belief, knowledge and opinion on smoking.
Results : Smoking prevalence was every low among female adolescents (1.5%) while male adolescents 10 times higher (20.3%) at wave 1. This difference exists
in all the 5 waves. The reasons for initiate smoking were similar for both male and female adolescents (more than 80% mentioned “Curiosity”). The reasons forchoosing the brand were also similar (taste and price). Female adolescents consider cigarette smoking is disgusting (63%) while only 39% of male adolescents
think so. Both male and female adolescents less accepts for women to smoke than for men to smoke. Female adolescents have better knowledge of harmfulof cigarette smoking than male adolescents do. 66 % of female adolescents consider cigarette smoking as “Very bad” while only 38% of male adolescents do.
Conclusions : Gender makes some differences with regards to smoking among Thai adolescents. Male adolescents smoke much higher than female adolescents
do. Although, there are some similarities in terms of reason for initiate smoking and choosing brand but female adolescents have more negative ideas aboutsmoking than male adolescent do.

P-Y1-06

Tobacco Free Students and Youth

Vijay Bhasker YETAPU, Sobharam MADAKA
VChangeU
Background: Students and young people are our top priority, students have always been at the forefront of social change they are not just the tomorrow's future
they must be the leaders of today. They have the energy, passion, ideas, and courage to deliver the action play if we script it. Methods: We at VChangeU help
young people by educating them what tobacco and alcohol really are, how occasional tobacco and alcohol consumption can lead to regular use and then to
addiction that can wreak havoc with health and well-being of entire family. Through school-based education programs and public information programs on
tobacco, alcohol and drugs we would like to keep the young generation away from these activities for lifetime. Awareness through Animated and Documentary
videos along with creative posters for effective impact. Results: Data collected from students and Staff of different Schools & Colleges. The majority ofStudents and Staff are not having awareness on Tobacco Smoke Pollution. Educated 6400 Students and staff on Tobacco impact on Health, Environment by toxic
cigarette butt waste and Deforestation in the Tobacco-Growing. Gathered more than 3000 student volunteers and 2000 young volunteers from different walks
through multiple awareness camps and events. Our website on Tobacco control receives
an average of 1000 hits every day. Created 100+ Social networking pages on Tobacco
Awareness to target the youth. Conclusion: Knowledge about tobacco’s harmfulness
has somewhat increased but is not sufficient, especially on Tobacco Smoke Pollution,
Toxic Cigarette Butt Waste and Cutting of tress and tree leaves for packaging of tobacco
products which are equally affecting the Environment apart from Health hazards Tobacco
causes. Tobacco awareness campaigns should be included in schools, colleges and othereducation institutes for effective control on tobacco usage among youth. Since the youth
who are addicted to tobacco may never be able to beat this addiction, leaving them tobattle the health consequences they will face in the future. Need to educate, support, andmobilize a generation of young leaders to fight against Big Tobacco to create enduringchange and unleash their potential as Change Makers and Change Agents of tomorrow.

P-Y1-07

A Trial of Tobacco-Free Lecture and Workshops for High School Students with Disabilities

Daisuke MATSUI1, Isao WATANBE1, Atsuko AOKI2, Masako SHIGETA1, Etsuko OZAKI1, Nagato KURIYAMA1, Yoshiyuki WATANABE1
Kyoto Prefectual University1, Kyoto Association for Tobacco Control2
Background:According to a large scale survey carried out in 1996 and 2008, the prevalence of smoking among high school students sharply decreased from30.7 % to 8.6 % for males, from 12.6 % to 4.6 % for females in Japan. However, it considered only students who attended regular high schools. Because smoking
habits are considered as a symbol of health disparity, smoking tends to remain higher among marginalized and disadvantaged people. In spite of this, there havebeen few investigations and interventions for disadvantaged youth in Japan.
Objective:(1) To conduct tobacco-free lecture and workshops at the high school for the visually impaired, hearing-impaired and intellectually-impaired(2) To survey visually-impaired and intellectual-impaired students on their attitudes toward smoking
Subjects:During 2009 to 2012, we conducted tobacco-free workshops for 287 students at 6 high schools for the visually impaired, hearing-impaired andintellectually-impaired 8 times. There were 82 students (Males; 47 and Females; 35) at 3 schools (2 for intellectually-impaired and 1 for visually impaired) which
agreed to participate in the survey.
Methods: The students completed the questionnaires before the workshops. The 2- hour workshop included a lecture and hands-on sections. The lecture
consisted of four parts; damage to body, nicotine dependence, the social context of tobacco and how to refuse an offer of tobacco. Items in the hands-on section
included disease models, foreign tobacco-packs, quit smoking information services. Students took part in role plays on how to refuse tobacco.
Results:The students concentrated during the lecture. There was joyful laughter at humorous video and other topics. The role-plays also had students' positive
participation, and cheers and applause erupted when students succeeded in refusing a smoking invitation. The incidence of smoking experience among students
was 10.9%, while the smoking prevalence among their families was 57.3%.
Discussion:The incidence of smoking experience among students was only 10.9%, but the incidence of smoking among people with disability might be hidden
in many cases. The awareness that smoking is not good for health was wide spread among students with disabilities already. However, the smoking prevalencein their families is extremely high and it is likely someone would recommend smoking to them in the future. Therefore research into how to help students
refuse smoking is required. The community should identify disparities in smoking prevalence among specific population groups and target these groups withspecifically designed education and support programs.

210

P-Y1-08

Exploring the Socio-economic Gradients in Tobacco Use among Adolescents Living in New Delhi and the Psychosocial
Factors Affecting This GradientManu R. MATHUR
Public Health Foundation of India
Tobacco consumption represents an emerging, significant, and growing threat to youth health in India. Every day, an estimated 5500 young people in India try
tobacco for the first time (Patel 1999).This situation is further complicated by the many forms in which tobacco is consumed in India. A few studies from India
points to the fact that tobacco is consumed most by people who are socially and economically marginalized. Adolescence is a very crucial phase for health, as
individuals during this period gain independence in making personal and dietary choices. In addition, behaviours are established and habits are formed duringadolescence which remains with an individual throughout life. This study aimed to explore the socioeconomic gradients in tobacco use of adolescents 12-15 yearsof age and examine the role of neighborhood social capital and social support in explaining the gradient in tobacco use among adolescents who are residents inthe city of New Delhi. The research was conducted as a cross- sectional study among 1400 adolescents 12-15 years of age belonging to three different groups
according to their area of residence in the city of New Delhi. These three groups were; adolescents from urban slums, from resettlement colonies (settlements
which have recently been regularized by the Government and were previously slums; marginally better off economically in comparison to slums) and from middle/
upper middle class homes. Adolescents were randomly picked from slums and resettlement colonies through multi stage random sampling. Data was collected
through an interviewer administered questionnaire, derived from World Health Organization’s, Health Behaviour in School Children (HBSC) questionnaire andthe Social Support Scale for Adolescents (SSAS) questionnaire. 185 (13.3%) adolescents reported ever use of tobacco in either smoked or smokeless forms.
There was a clear significant gradient in tobacco use, with the adolescents from middle/ upper middle class homes reporting the least and adolescents from urban
slums reporting the maximum prevalence of tobacco use (p < 0.0001). Psychosocial factors like social capital and social support attenuated the gradient but did
not eliminated it completely, showing that area of residence is a very important structural determinant of tobacco use. There is a clear need to target the upstream
determinants of tobacco use in order to work towards cessation in adolescents. Future policies aiming to improve the living conditions of adolescents and statusof relative deprivation will play a crucial role in reducing disparities in tobacco use and cessation among adolescents.

P-Y1-09

College-based Smoking Cessation Intervention for Youths: A Pilot randomized Controlled Study

Takayuki HARADA
Mejiro University, University of Tokyo
Youth smoking is one of the biggest public health concerns in the world (WHO, 2011). However, research and practice on smoking cessation has been
predominantly focused on adults and those targeting youths are limited, and therefore available evidence for youth smoking cessation intervention is also limited(Fiore et al., 2008).
I this study, a college-based smoking cessation program was developed based upon the cognitive-behavioral relapse prevention model (Marlatt & Donovan,
2006) and its effectiveness was evaluated on the pilot basis. The participants are 13 college students. They were randomly assigned either to the intervention
group (n=8, mean age = 20.9) or the control group (n=5, mean age = 22.2) by means of the computer generated random numbers. The intervention group received
the program in a group once a week for 5 weeks. The control group was provided with the psycho-educational smoking cessation materials. The program consistsof 5 sessions and the topics covered: (1) identification of smoking triggers, (2) coping skills training, (3) handling of peer pressure, (4) emotional management,(5) alternative activities, (6) coping with craving, etc.
The FTND score was measured before the treatment and no significant difference was found between the groups (t(11)=.361, n.s.). Nobody was dropped outof the program and the mean participation rate was 87.5%. At the 3-month follow-up period, only one out of 8 participants of the treatment group continued
abstinence and none of the control group participants stopped smoking. No significant difference was observed (χ2(1) = 0.678, n.s.). In terms of other outcome
measures, although the treatment group showed more maximum abstinence dates and less mean nicotine consumption, they did not reach the significant level(t(10)=1.74; t(10)=1.67).
The results did not suggest the effectiveness of the program and it is obvious that more research is necessary to draw the definitive and meaningful conclusions.
However, it is encouraging that some promising results were obtained and the program dropout rate was low and this means that the program was attractive tothe college students.

P-Y1-10

Japanese Youth Participated in a Tobacco-free Event in Hawaii and Learned the Concept and the Background

Masako SHIMOZONO1, Misato FURUNO2, Atsuko OHTSUKI2, Kaoru INOUE2,3, Masako SHIGETA2,3, Nicole SUTTON4, Mark LEVIN5
Kyoto Prefectural University1, Kyoto Prefectural University of Medicine2, Kyoto Association for Tobacco Control3, REAL, Hawaii4, Hawaii University5[Background] In Kyoto, youth carried out some tobacco-free activities. For these activities, we researched youth activities on the Internet and learned lots from
Kick Butts Day (KBD) Events which are held all over the US.
[Objective](1) To participate in a tobacco-free activity which was one of the biggest youth events held continuously and widely in the US (2) To learn aboutorganization and practical methods of KBD events and to compare them with our activities (3) To create a network between the youth in Hawaii and Japan[Methods] In APACT 2010, one of the directors of Kyoto Association for Tobacco Control (KATC) contacted the director of REAL; a youth team which started
in 2000 around Hawaii and continue to work actively building a program for youth, by youth. Then the director and four university students (1; graduate student,
1 medical student, 1 nursing student and 1 psychology student) participated in a KBD Event held by REAL in Honolulu on 14th Feb, 2011.
[Results]At first we learned the history of tobacco control policies in Hawaii from the professor of Hawaii University. An indoor smoke-free policy wasestablished in 2006 after much controversy in Hawaii. The policy is working well and no economic impact has been observed. The day before the event wejoined a group which was preparing resources and presentations at the REAL Headquarters. The slogan in 2011 was “Share the Love” and the main goal was
reducing tobacco industries influence in Hawaii storefronts. Our recently slogan “Share the facts about tobacco” was somewhat similar but the Hawaiian program
attached more importance to sales methodology than KATC. On the day we met a lot of members and visitors (11 ~19year old students from all over Hawaii).
The introduction and slideshow were very appealing and fun. In the afternoon all of us approached senators with a message from the youth and marched aroundcity hall. At last Hawaiian youth appealed for a stricter tobacco-control policy with a dance and performance and some senators responded positively. After the
projects, we and REAL members communicate using Facebook and e-mail.
[Discussion]There is more sufficient awareness of health impacts of smoking among people in Hawaii than Japan. Since the awareness of the fact around tobacco
is widespread, the focus of the REAL activities has moved to combatting promotion of tobacco. What the two groups had in common was a sense of energy,
excitement and a big influence on the community. We believe that youth activities are very important in tobacco control.

211

P-O-04

Development of Stage-matched Smoke-free Preventive Educational Model for Children and Youth in Hong Kong

Vienna WY LAI, Lisa MM LAU
Hong Kong Council on Smoking and Health
Background and Objectives: According to the recent surveys in Hong Kong, over 60% of daily cigarette smokers started their weekly smoking habit in adolescence (age 10 – 19)(table 1) with different reasons. To prevent youngsters from starting their first cigarettes, COSH has developed a stage-matched preventive educational model for children and youth
Hong Kong before their transition to adulthood. Theoretical Background: Erikson's stage theory (Erikson, 1993) stated that each people would come across various challenges
from biological and sociocultural needs during the development from infancy to late adulthood. Therefore, when COSH developed a series of smoke-free educational programmes,
the developmental challenges and needs of children and youth in the first few stages were addressed before their transition
to: adulthood.
Health ofTalks
for Pre-schoolers:
COSH
Abstract Title
Development
Stage-matched
Smoke-free Preventive
Modelcanfor Children
Youthin Hongon
Kong
has designed tailor-made health talk programmes for pre-schoolers at their stage of facing the challenge of initiative versus guilt. TheseEducational
health talks
educateandthechildrentheName ofthem
Authors
ViennaWY LAI, Lisa MM
LAU
hazards of smoking and secondhand smoke thus the children can understand the negative effects of smoking and motivate
to :become
a smoke-freeambassador
for their family
Affiliations :Hong Kong Council on Smoking and Health (COSH)
members. Education Theatre for Primary School children: During the stage of forming moral values, understanding cause and effect as well as learning to share and cooperate withpeers, COSH developed interactive theatre programme touring around primary schools as an intervention of youth smoking
in the territory. Through an entertaining performance, theBackground and Objectives
students can understand the importance of rejecting first cigarettes, their right in living in and constructing a smoke-freeenvironment. Development of smoke-free programmes by
According to the recent surveys in Hong Kong, over 60% of daily cigaretteteenagers: Teenagers unavoidably face identity crisis along their adolescence and face role confusion. In this stage, they
arestarted
moretheirawareof smoking
peer support
recognition.
smokers
weeklyhabit in andadolescence(age 10 Therefore,– 19) (table 1)with different leadershipreasons. To training
prevent youngsters
from starting
their first cigarettes,
COSH provides them various platforms, such as “Secondary School Video Competition” and “Smoke-free youth ambassador
programme”
to introduce
smokeCOSH
has developed
a stage-matchedmodelchildrenfree programmes in an innovative spirit for their peers. Active participation of young adults in tobacco control: It
is importantto nurture
youngpreventive
adults aseducational
successors
in fortobaccoand youth Hong Kong before their transition to adulthood.
control, at the stage of a clear personal identity as they are the future of our society. COSH designed relevant programmes to engaging them in supporting smoke-free education andtobacco control. Many youth leaders had joined us as facilitators, counselors and advocators for youth leadership Table 1 : Age of Starting Weekly Smoking
training programmes, recruitment of smokers at cessation contests and collection of signatures for raising tobacco
Age Groups of Starting
Males
Males
Females
Femalestax respectively. Conclusion: To reduce the smoking prevalence in Hong Kong, it is necessary to encourage theWeekly Smoking
2009
2010
2009
2010
current smokers to quit as soon as possible and to prevent people from starting the smoking habit. Our prevention
<10
1.3%
1.2%
§
§
programmes not only facilitate children and youth to stay away from cigarette smoking, their participation had
10-19
65.3%
67.9%
59.3%
61.9%
motivated many current smokers to quit smoking. COSH will design further effective prevention programmes and
20-29
30.8%
28.8%
33.6%
30.8%
territory-wide campaigns so as to strengthen the role of youth to construct a smoke-free Hong Kong.
>30
2.6%
2.1%
6.4%
7.1%
Reference: Erikson, Erik H. (1993). Childhood and Society. New York, NY: W. W. Norton & Company
Source : 2010 Thematic Household Survey Report No. 48, HKSAR Government

P-O-05

SWOT Analysis on Raising Tobacco Tax in Hong Kong

Lisa MM LAU, Vienna WY LAI
Hong Kong Council on Smoking and Health

Theoretical BackgroundErikson's stage theory (Erikson, 1993) stated that each people would come acrossvarious challenges from biological and sociocultural needs during the developmentfrom infancy to late adulthood. Therefore, when COSH developed a series ofsmoke-free educational programmes, the developmental challenges and needs ofchildren and youth in the first few stages were addressed before their transition toadulthood.

Introduction: Hong Kong Council on Smoking and Health (COSH) has been advocating for raising tobacco
tax with tobacco control organizations and experts
Health Talks for Pre-schoolers
for years and successfully strived for public support for raising tobacco tax for 50% and 41.5% in 2009 and2011
respectively.
these
two recent
increments,
COSH
has designed
tailor-madeAfter
health talkprogrammes
for pre-schoolers
at theirstage
of facing thelevel
challenge
initiativeBankversus (67%)
guilt. Thesecanthe tobacco tax of Hong Kong is contributing around 68% of the retail price which is just reaching theminimum
fo ofWorldbut healthstill talks
lower
educate the children on the hazards of smoking and secondhand smoke thus thethan the minimum level suggested by World Health Organization (70%). Having consolidated recent experienceinadvocatingfortobacco
tax,
the
paper
aims
children can understand the negative effects of smoking and motivate them tobecome aon
smoke-freetheirinfamilyto analyse the strengths, weaknesses, opportunities and threats of Hong Kong to formulate strategic actions
raisingambassador
tobaccofortax
themembers.
near future. SWOT
Analysis: 1. Strengths : Majority of Hong Kong population (over 80%) is non-smokers who have been expecting for a smoke-free Hong Kong by supporting
Education Theatre for Primary School children
expansion of no smoking areas and raise tax for smoking cessation. 2. Weakness : Tobacco industry andDuringretailers,
especially the newspaper retailers and hawkers
the stage of forming moral values, understanding cause and effect as wellalways questioned the effectiveness of the tax measures in reducing smokers but only inducing moreassmuggling
activities
on illicit
cigarettes.
Meanwhile,learning to shareand cooperatewith peers,
COSH developed
interactive
programme
touring3.aroundprimary schools
as an interventionof youthsmokers expressed that the Government exploiting of the rights of grassroot smokers in “enjoying” legal theatre
tobaccoproducts.
Opportunities: While176 countries
smoking in the territory. Through an entertaining performance, the students can
had signed the Framework Convention on Tobacco Control, more and more Asian pacific countries have raised tobacco tax as an essential tobacco control
measures in recent years which could generate effective ripple effects to adopt taxation policy in strengthening tobacco control. 4. Threats : Compared with
the neighbouring cities and countries, the retail price of cigarettes in Hong Kong is undoubtedly slightly higher thus contributes to a lower smoking prevalencein Hong Kong. In addition, the free trade port of Hong Kong would attract active smuggling activities on tobacco and many other products. Discussion andConclusion: As tobacco is responsible for 7000 deaths and more than HKD5 Billion community cost in Hong Kong every year, stringent tobacco control
measures must be taken continuously. The number of calls to quit line surged after raising tobacco tax in 2009 and 2011 and drop of youth smoking rate after
2009 clearly illustrated the effectiveness of taxation policy on smoking cessation and prevention of youth smoking. Learning from overseas experiences, theappropriate response to smuggling activities is to crack down on criminal activities while tobacco tax can reduce the cigarette consumption. Furthermore,
tobacco tax revenue can channel more resources for public education, cessation services and strengthen enforcement on illicit trade. In order to expand thecommunity advocacy network for further increment on tobacco tax and implementation of effective tobacco control measures in Hong Kong, COSH will join
hand in hand with more strategic partners and unite the general public through various platforms so as to construct a smoke-free Hong Kong in the near future.

P-O-06Media Advocacy in Promoting a Smoke-free Community

Vienna WY LAI, Lisa MM LAU
Hong Kong Council on Smoking and Health
Introduction
Since the establishment of Hong Kong Council on Smoking and Health (COSH) in 1987, COSH has been concerning about the tobacco control progress in Hong
Kong and sparing no effort in “Education and Publicity”, “Information and Research” and “Policy Advocacy” to build a smoke-free Hong Kong.
In the past 25 years, COSH has produced a lot of popular Announcement of Public Interests (APIs) with the aims to educate the public and raise their awarenesson the hazards of cigarette smoking and secondhand smoke, to tie-up the progress of tobacco control, to advocate for public support on smoke-free legislations
and promote smoking cessation. Through the mass media, the smoke-free messages could be effectively disseminated to the general public.
The aim of this paper to review the changing strategies of COSH in producing APIs to meet different stages of public education, policy advocacy and reflect thehealth consequences of cigarette smoking with new evidence from scientific researches.
AnalysisYear 1990s - 2000
Since many smokers underestimated the impacts of cigarette smoking, COSH adopted scary tactics to arouse the public awareness on the health impacts on
smoking.
To combat the impacts of tobacco advertisements and promotion campaigns on youth smoking, COSH also made use of APIs to encourage youth not to be misledby the image of cigarette smoking from tobacco industry.
Year 2000 – 2006
While COSH was advocating for smoke-free legislation in early 2000s, COSH tried to adopt innovative approach to raise the public awareness on secondhand
smoke so as to gain support from the non-smokers on smoke-free legislations.
Based on a scientific research, “Secondhand some increase stroke deaths by 50% in non-smokers” conducted by The University of Hong Kong. With an estimateof 1,324 deaths per year in non-smokers from various fatal diseases are associated with secondhand smoke exposure at home or work, COSH use a humourous
approach to raise public awareness on the health hazards of secondhand smoke.

212

Author Index
A
ABDULLAH, Abu S.
157
ABE, Kayoko
164
ABE, Kazumasa
138
ABIDIN, Emilia ZAINAL184
ACHARYA, Dilip K.
173, 194
ADACHI, Masaaki
145
AGARWAL, Deepti
137
AHLUWALIA, Jasjit S.
165
AHMED, Saifuddin
193
AHSAN, Abdillah
124, 136, 183, 204
AIHARA, Yasushi
145
AKAO, Masaru
140
AKHTER, Sharmin
119
AKIYOSHI, Ogimoto
139
ALAM, Syed Mahbubul
119
ALAMPAY, Mary Jocelyn F.
190
ALDAY, Jorge
97
ALLEN, Matthew
130, 131AMAGAI, Kenji
92
AMIDJAJA, Moch. Tauchid TJAKRA132
AMIYA, Rachel M.
158
ANDOU, Syouko
155
ANTONIO, Maria Soledad
97
AOISHI, Keiko
149, 172
AOKI, Atsuko
103, 134, 135, 150, 156, 179, 197, 210
AOKI, Atsuko
151
APIRAKMONTREE, Jamsai
187
ARAI, Kazunori
81
ARIYAWORACHAI, Pantawit
117
ARMADA, Francisco
132, 133
AROONPRAPAN, S.
90
ARORA, Monika
90
ARORA, Nishi
196
ARUNPRAPHAN, Siripen
82, 137
ASAHARA, Noriko
138
ASAHARA, Noriko
140
ASAI, Yuko
164
ATTIYAH, Omar S.
186
AUEMANEEKUL, Naruemon
200, 203
AUFA, Badra AL112
AUGUSTSON, Erik M.
161
AUNG, Thuya
174, 207
AWANG, Rahmat
79, 96, 112, 173, 201

B
BABA, YahyaBAKUL, Md Aminul I.
BALANE, Marysol

79, 96, 173
183
97BALĂZS, Pĕter
BAM, Tara S
BELLEW, BillBENITANI, Ayumu
BESSHO, Fumio
BETTCHER, Douglas W.
BHAKTI, Astera Primanto
BHALANG, Kanokporn
BHUTIA, Tshering
BILLAVA, Narayan N.
BITARI, Wilda Af’idah
BLAKELY, Tony
BORLAND, Ron
BOWLING, JM.
BUAJEEB, Waranun
BULLEN, Christopher

127, 148, 181
88, 132
97
145
118
72
75
137
100, 112, 182, 188, 199
130
192
185
71, 91, 105, 112, 118, 143,
144, 169, 189, 201, 205, 210
183, 202
137
93, 160CCARTER, Kristie
CHADHA, Devika
CHAIKOOLVATANA, AnunCHAIKOOLVATANA, Anun B.
CHAIKOOLVATANA, Cholada
CHALOUPKA, Frank J.
CHAN, Sophia
CHAN, Sophia
CHANG, Yvette
CHANPREMPRUNG, Suwimon
CHANTARUKHA, Kannika
CHATURVEDI, Pankaj
CHATURVEDI, Satyen
CHEAH, Chris
CHEN, Gong-bo
CHEN, Lei
CHEN, Shu-Li
CHEN, Ted T. L.
CHEN, Wenli
CHEN, Ying-Chun
CHEN, Yu
CHEN, Yuan-li
CHENG, Kai-liang
CHENG, Wei-Erh
CHI, Yu-Chiu
CHIA, Janelle
CHIDA, KIe
CHILAKUL, Phenprapa
CHIMORI, Yoshihiro

185
100, 112, 126, 175, 181,
182, 188, 196, 199, 203
189
187
187
80, 98, 106, 120, 122, 194
91
94
95
170
119
128
99
146, 158
169
177
185
136
85
185
95
169
177
80
143
146
163
119
166

213

CHINDAVIJAK, Somjin
CHO, Hong-Jun
CHO, Sung-il
CHOU, Ming-Yueh
CHOU, Ming-Yueh
CHOWDHURY, Ishrat
COBIAC, Linda
COLLIN, Jeff
CONNETT, John E.
COWIE, Nathan J.
CUMMING, K M.

82110, 165
97, 194
159
162
179
185
204
165
155
105

D
DAGLI, Elif
DAI, Zhen
DAIDA, Hiroyuki
DALEY, Vivien A.
DALLEY, Amelia
DANG, Vang V.
DAO, Son T.
DARBY, Sarah C.
DARI, Anki Novairi
DAVID, Annette M.
DEGOLLACION, Ralph Emerson P.
DENNISTON, Ryan
DENNISTON, Ryan C.
DEVADIGA, Arishka
DEVI, Sarita
DEWI, Arika
DHUMAL, Gauri G.
DOGANAY, Sinem
DOI, Eriko
DOI, Takashi
DOLAMPORNPHISUTH, Thanut
DOROTHEO, Edgardo Ulysses N.
DOUNGMALA, Wanpen
DRIEZEN, PeteDRIEZEN, PeteDUAGMALA, Wanpen
DUAN, Yixin

113
127, 169
84
167
130
123
125
126
196
94
125
204
107
137
158
154
99
79
143
103, 134, 135, 156, 179, 197
161
76, 126
119
79, 96, 157, 194, 201
173
180
161

E
EDWARDS, Richard
EISCHEN, Sara
EKAPUTRI, Nurani P.
EKPANYASKUL, Chatchai
ELTON-MARSHALL, Tara
EMOTO, Noriaki
ENDO, Akira
ERGOR, Gul
ERICK, Stephanie
ETO, Toshiharu

79, 101, 118, 132
165
195
175
202
142, 143
176
79
117
149, 172F
FALETAU, Julienne
177
FATYA, Atikah I.
140
FEBRIYANTI, Erna
196
FENG, HuanFeng
169
FLOREK, Ewa K.
83
FOGARASI-GRENCZER, Andrea Z.
127, 148
FOLEY, Kristie L.
127, 148
FOLEY, Kristie Long
181
FONG, Geoffrey T.
79, 80, 91, 96, 98, 99, 104, 105,
110, 112, 118, 120, 122, 144, 157, 169,
170, 173, 189, 194, 195, 201, 202, 210
FOOKS, Gary J.
204
FOONG, Kin
101, 183, 202
FU, Dongbo
89
FUJII, Naohiko
166
FUJIMARU, Ikuyo
149
FUJIOKA, Seiji
129
FUJITO, Takatoshi
177
FUKUDA, Takashi
121
FUKUTOMI, Satoshi
156
FURUNO, Misato211
FURUSE, Midori
141
FURUTANI, Emina
147

G
GAINROJ, Pariya
GAN, Quan
GAO, Hanchang
GAO, SongGARÇON, LoïcGELBERG, Lillian
GENDALL, Phliip
GIFFORD, Heather
GILMORE, Anna B.
GLANTZ, Stanton A
GLOVER, Marewa P.
GOEL, Sonu
GOHMA, Iwao
GOLDADE, Kate
GOLUSINSKI, Wojciech
GOTO, Rei
GRAHAM, DavidGRANT, Eric J.
GREEN, Annika C.
GRILLS, Nathan
GUO, Hongfei
GUO, Ruijun
GUPTA, Prakash
GUPTA, Prakash C.

H
HAIRI, Farizah MOHD

214

118
199
161
122
132, 133, 142, 143
165105, 109, 145
101
204
104
155, 160, 177
122
164
165
83
121
115
126
202
90
165
85
202
99, 20093

HAJEK, Peter
HAMAMOTO, Ayaka
HAMMOND, David
HAN, Phyu T.
HANAFFI, Siti H. MOHDHANIOKA, Takashi
HARADA, Takayuki
HARANO, Kazuyoshi
HARNROONGROJ, Talabporn
HASEGAWA, Junichi
HASEGAWA, Koji
HASEGAWA, Koji
HASHIGUCHI, Takeo
HASHIM, Haslina
HASSAN, Noraryana
HATA, Yoshinobu
HAYASHI, Kenji
HEALEY, Benjamin
HEGDE-SHETIYA, Sahana
HENSE, Hans-Werner
HIBINO, Chikako
HIGAKI, Jitsuo
HIGASHI, Haruhiko
HIGUCHI, Susumu
HIGUCHI, Susumu
HIRAGA, Noriko
HIROHASHI, KaoriHIROTA, Satoshi
HOEK, Janet
HOEK, Janet
HOLUMYONG, Charamporn
HOMMA, Sakae
HORIE, Rumi
HORTON, Susan
HOSHINO, Keiichi
HOSOKAWA, Yohei
HOSSEIN, Monowar
HSUEH, Kuang-Chieh
HSUEH, Kuang-Chieh
HSUEH, Shu-Chun
HU, Jen-Huan
HUANG, Chih-Ling
HUANG, Hui-Wen
HUANG, Jidong
HUANG, Pintong
HUANG, Song-Lih
HUANG, Yibee
HUNG, W. T.
HUNG, Yu-Yun
HURT, Richard D.
HUSSAIN, AKM Ghulam
HUYNH, Nam V.
HYDEN, McRobbie

162
142
110, 118, 169, 189, 200, 202, 210
174, 20785
82, 83, 136, 158
211
120
140
167
138
140
206
112
79, 96, 173
145
159
79, 118, 132, 167
137
94
164
84, 139
139
96
209
208
129
197
79, 105, 109, 118, 132, 145, 167
172
91, 143, 144
144132, 133, 142, 143
110
145
150
206
159
162, 166
162
173, 185
166
166
120, 122
85
178, 197
184, 197, 205
81
178
93, 114
200
123
162

I
IEDA, Shigeharu
IGARASHI, Ataru
IIDA, Hiroki
IIDA, Mami
IIDA, Yuko
IJIRI, Noriko
IKEDA, Maki
IKEDA, Takayoshi
IMAMURA, Satoshi
INAGAKI, Koji
INO, Toshihiro
INOUE, Kaoru
INOUE, Masashi
INOUE, Tokiko
ISHIKAWA, Nobuhito
ISHIKAWA, Shinji
ISHRAT, Ishrat C.
ISLAM, Md Akramul
ISODA, Hiroko
ISOJIMA, Yasushi
ISOMURA, Takeshi
ITANI, Osamu
IWANAGA, Suketaka
IZUMI, Masaki

176
121
94
94
138
179
92, 209
185
92
176
168
103, 150, 151, 156, 163, 168, 197, 206, 211
147
152
152, 156
150
183
88
180
147
168, 171, 176
92, 209
120
208

J
JAISUPAP, Parichat
JAMPAKLAY, Aree
JANG, TaeWon
JANWANTANAKUL, Prawit
JAROENSATHAPORNKUL, Jirawat
JASNI, Nur Hanani
JEE, Sun HaJIANG, Yuan
JIENMANE-CHOTCHAI, Sutha
JIMBA, Masamine
JIN, Xuezheng
JINGHUA, Ni
JIRATHANAPIWAT, Worrawan
JUANITAJUMIA, Jumina
JUNG, Hyun-Suk
JUNG, MaanHong
JUNNUAL, Niyom
JUNNUAL, Niyom

180
91, 143, 144, 189
166
162
195
79, 96, 173
100
110, 120, 122, 169, 170, 201
82
158
192
144
117
134
196
195
166
187
189

K
KADAM, Rajashree S.
KADIR, Rahimah A.
KAIDA, Fumiko
KAIDO, Yoko
KALAMPAKORN, Surintorn

126, 175, 181, 199
93
129
171
152, 154

215

KAMEI, Hidehiko
KAN, Satomi
KANDA, Hideyuki
KANEITA, Yoshitaka
KANEKO, Masahiro
KANG, Dae Yong
KANG, Zee Yong
KANO, Masato
KAO, Wayne
KARUPPIAH, Vijayalakshimi
KASAMATSU, Takahiro
KASHIWABARA, Mina
KASUGAI, Shohei
KATAYAMA, Hatsumi
KATAYAMA, Ritsu
KATO, Masataka
KATO, Masataka
KATO, Mayumi
KATSUMI, Yukio
KAWABATA, Tomoko
KAWAI, Atsuko
KAWAI, Atsuko
KAWANAMI, Yukiko
KAWANE, Hiroshi
KAWASHIMA, Keiko
KEIKO, Yoshino
KENGGANPANICH, Mondha
KHAERUNNISA, Tania
KHAIRI, Muhammad
KHAN, Halilol R.
KHANCHANDANI, HemaKHARA, Milan
KHATRI, Sushil
KHEAM, TheyKHONGSAMAI, Thanida
KILINC, OğuzKIM, Eun Ji
KIM, Eun Young
KIM, Il-Soon
KIM, Jaehyung
KIM, Seoung-ryul
KIM, Sun-Hee
KIM, Yeol
KIMURA, Kohichi
KIMURA, SkyeKIMURA, Takashi
KINOSHITA, Natsuki
KINOSHITA, Yoko
KINTARAK, Sompid
KIRA, Anette C.
KISARA, Emi
KITA, Tetsuro
KITADA, Masako
KITAGAWA, Jun
KITING, Ayke S.
KLINSOPHON, Thaniya

216

176
206
96, 20992, 96, 209
130
100
95
160, 176
157
176
149
130, 133, 142, 143
83
150
102
191
193
94
129
209
146, 186
178
160
162
183, 188, 209
178
119
189
195
112
99, 111
139, 160
158
124
153
79
86, 198, 207
100
101
101
135
165
170, 194, 195, 202
80
117
147
147
134
137
155, 177
183, 188, 209
206
176
138
136, 183
162

KOBAYASHI, Jun
KOBAYASHI, Jun
KOBOON, Thawatchai
KODA, Shinichi
KOGURE, Ayumi
KOKAWA, Asuka
KOLANDAI, Mary Assunta
KOMATSU, Kenichi
KOMIYAMA, Maki
KOMIYAMA, Yoko
KOMODA, Hiroshi
KOMOTO, Tatsuhiro
KOMUKAI, Jun
KONDO, Shuji
KONDO, Yoko
KONDO, Yuriko
KONGSIN, Supathita
KONKAEW, Teeranoot
KONKEAW, Teeranoot
KOSEN, Soewarta
KROBTHONG, Amporn
KUJAWA, Anita
KULZA, Maksymilian J.
KUMAR, Ravinder
KUMAR, Ravinder
KUMSUPSIRI, Nampung
KUNIMI, Yuji
KUNITOMO, Fumio
KURAMOTO, Siori
KURIOKA, Narito
KURIOKA, Sumiko
KURIYAMA, Nagato
KUROSAWA, Hajime
KUROSAWA, Kazuo
KURUMA, Akinori
KUSAKA, Keiko
KUSUMOTO, Misato
KWAK, Sang Mi

156
158
170
89
155
164
102
183, 188, 209
138, 140
113, 114
156
183, 188, 209
89
209
96
177
119
144
143
92, 129
161
83
83
179, 198
192
117
130
160
150
103, 134, 135, 197
134
152, 156, 206, 210
81
168
191
120
143
195

L
LAD, Narayan
LAI, Vienna
LAL, Pranay
LAL, Pranay
LANDLESS, PeterLATIFF, Sultana Abdul
LAU, Lisa
LE, Hien T.
LEE, Cheol Min
LEE, Eon Sook
LEE, Jun Hyung
LEE, Jung-Ah
LEE, S. H.
LEE, Shu Yi
LEE, Sungkyu

112, 182, 196, 199
87, 105, 212
103, 122, 125, 133, 192
179, 198
73
158
72, 87, 212
123
100
170
170
165
81
151
101, 104, 108

LEUNG, Chi Chiu
LEVIN, MarkLI, Lin
LI, Qiang
LI, Xiaobei
LI, Zhi’an
LIBORO, Nichola L.
LIN, Bo-Hong
LIN, Ching-Li
LIN, Hsiu-Lian
LIN, I-Fen
LIN, Li-Ju
LINDORFF, Kylie. J.
LING, Annie
LIU, Jen-Tao
LIU, Jun
LOPEZ, Carmen Audera
LU, Tzu-I
LYMAN, Annabel

88108, 211
169, 201
120, 122, 169, 170, 201, 202
192
85
125
84
136, 173, 185
143
178
143
106
146, 158
143
177
90
173, 185
131

M
MA, Lin
MACKAY, Judith
MADAKA, Sobharam
MAHULI, Amit
MAHULI, Simpy
MAKINO, Sohei
MANABU, Musashi
MANITSORN, Thongsuk
MANWONG, Mereerat
MARDLIYAH, Walidatul L.
MASAKO, Kitada
MASUI, Shizuko
MATHUR, Manu R.
MATOBA, Yukiko
MATSUBAYASHI, Atsumi
MATSUDA, Akiko
MATSUI, Daisuke
MATSUI, Daisuke
MATSUMOTO, Kenji
MATSUMOTO, Naoko
MATSUMOTO, Naoko
MATSUNAMI, Yoko
MATSUOKA, Hiroshi
MATSUOKA, Shinich
MATSUZAKI, Michiyuki
MAUBACH, Ninya
MAZTA, Salig R.
MCCOOL, Judith
MCGALE, PaulMCKENZIE, Jeanie
MERCADO, Susan P.
MIKAMOTO, Nahomi
MINOWA, Masumi
MITSUHASHI, Kimiyoshi

85
71
210
137
137
81
178
117
187
176
178
156
211
145
164
167
103, 135, 152, 197, 206, 210
152, 156
89
151
152
141, 146, 178
130
145
86
172
192
131
126
131
94
103, 150, 151, 152, 156, 197, 206
96
145

MIURA, Norimasa
MIYAKE, Yoko
MIYANO, Sayori
MIYAZAKI, Kyoichi
MOADSIRI, Ada
MOCHIZUKI, Yoshikatsu
MOCHIZUKI-KOBAYASHI, Yumiko
MOETARA, Warren
MOHAMAD, Hamid J. JAN
MOHAMED, Nurul
MOM, KongMONGKOLNCHAIARUNYA, Surat
MOODIE, Rob
MORI, Hiromi
MORI, Masahiro
MORI, Nagisa
MORI, Tadaaki
MORI, Toru
MORISHIMA, Yuichi
MORITA, Ichizo
MORITA, Junji
MORITA, Toshisuke
MOURI, Takako
MOURI, Takako
MUKAE, Hiroshi
MULMI, Shanta L.
MUNAKATA, Motohiro
MUNAKATA, Tsunetsugu
MURAKAMI, Tomoya
MURAMATSU, Hiroyasu
MURATA, Chisato
MURAYAMA, Harumi
MURAYAMA, Katsushi
MURAYAMA, Katsushi
MUTSUKAWA, Hiroko
MUTTI, Seema
MYAT, Su M.
MYINT, Tun

167
191, 193
171
71
130
163
109, 187
155
85, 141
184
184, 197, 205
182
90150, 209
156
132, 133, 142, 143
103, 197, 206
88
156
176
80
144
151
152
160
134, 201
83
172
171
174
139
193
131
193
147
200, 202
174, 207
207

N
NAGAI, Takayuki
NAGAOKA, Noa
NAGASAWA, EmikoNAGASHIMA, Tomomi
NAILUFAR, Fanny
NAKAGAWA, Hidekazu
NAKAGAWA, Natsumi
NAKAGAWA, Natsumi
NAKAGAWA, Yukiko
NAKAHARA, Toshitaka
NAKAKUKI, Kazunori
NAKAKUKI, Kazunori.
NAKAMURA, Jun
NAKAMURA, Masakazu
NAKANO, Wakako

139
138
145
171
191
130
191
193
150
120
129
138
159
95, 115, 156
159

217

NAKAYAMA, Risa
NAKAZAWA, Atsuko
NAKAZONO, Tomoaki
NAMASIVAYAM, Amrita
NARAHARA, Hiroyuki
NARGIS, Nigar
NAYAK, Nayanatara S.
NAZAR, Gaurang P.
NEUNER, Bruce
NEZU, Yoko
NGHIEM, Nhung
NGUYEN, Minh T.
NGUYEN, Nga Q.
NIMPITAKPONG, Piyarat
NIMPONGPAN, MaleeNISHIDA, Chinatsu
NISHII, Kiyomi
NISHIMOTO, Takashi
NISHIMURA, Kazuhisa
NISHIMUTA, Toshiyuki
NOAMI, Megumi
NODA, Hiroyuki
NOGAMI, Hiroshi
NOGUCHI, Toshihide
NOMURA, Akemi
NOMURA, Akemi
NOOR, Norhayati MOHDNOOSORN, Narongsak
NOOSORN, Naroongsak
NORDIN, Amer Siddiq AMER
NUBAIRI, Ahmad R.
NURHIDAYATI, Evi
NURMANSYAH, Mochamad I.

150
151, 152
147
158
166
98, 107, 122, 157, 200, 202
130
90
94
174
185
125
125
133, 196
119
160
150
171
139
174
120
73
123, 142
176
191
193
85
133
148
93
112
192
112, 176

O
O’CONNOR, Richard J
OAK, ChulHo
OAKU, Tatsuro
OBARA, Misato
OGIMOTO, Akiyoshi
OH, Dong Jin
OH, Su F.
OHASHI, Katsuhide
OHIDA, Takashi
OHNO, Kumiko
OHSAWA, Isao
OHTA, Tomoko
OHTSUKI, Atsuko
OIKAWA, Akari
OJIMA, Miki
OKAMOTO, Chizuru
OKAMOTO, Koki
OKAYAMA, Akira
OKOLI, Chizimuzo T.
OKUNO, Ayako

218

194
166
177
164
84
85
163
193
92, 96, 209
179
176
179
211
164
83, 158150
108, 208
147
87, 139, 160
166

OKUYEMI, Kolawole S.
OLIVER, West
OMAR, Maizurah
ONISHI, Aki
ONO, Koji
ONO, Yumi
ONO, Yurie
OOKITA, Yasufumi
OSAKI, Yoneatsu
OSHIMA, Akira
OTAKE, Shuichi
OTANI, Tetsuya
OZAKI, Etsuko
OZAKI, TetsunoriOZASA, Kotaro
OZASA, Kotaro
OZE, Isao
OZE, Isao

165
162
79, 96, 112, 173, 201
142
94
171
150
135
96, 209
156
186
176
152, 206, 210
82
126
151
155
155

P
PAEK, Yu-Jin
PAL, Jaspreet
PALKONDA, Vijay Anand R.
PAN, Lee-Fei
PAN, Yaodong
PANDA, Rajmohan
PANDEY, Basu D.
PANPAKDEE, Orasa
PARDEDE, Elda L.
PARK, Eunja
PARK, EunKee
PARK, Susan
PATIL, Deepak
PATIL, Deepak J.
PATON, Chris
PATWARY, Shameem H.
PAU-ARMART, Ittipol
PAUL, Jeremias
PAUSAWADI, S.
PAUSAWASDI, Somsri
PAWAPUTANONT, Chawala
PEACE, Jo
PEAREE, Gaous
PEDERSON, Ann
PEDNEKAR, Mangesh S.
PENZES, Melinda
PERSAI, DivyaPERUCIC, Anne-Marie
PETO, Richard
PHAM, Hoang Anh T.
PHANSOPKAR, Sushil A.
PHARUENG, Preeyaporn
PHETPHOOM, Chakgarphan
PICHAYAKUNMONGKOL, Chulunee
PIEKOSZEWSKI, Wojciech

78
99, 128
128
159
161
151, 164
158
153
183
194
166
194
181
126
155
128
146
74
180
90
187
101
119
87
99, 200
181
151, 164
107
126
123
137
189
133, 196
199
83

PIES, Claudia
PILANKAR, Ajay
PINYOSIRIKUL, Umaporn
PISANSARAKIT, B.
PONGPAEW, Maleewan
PORTERFIELD, Matthew
POUDEL, Krishna C.
POUDEL-TANDUKAR, Kalpana
POUNGCHAN, Jamchan
PRABANDARI, Yayi S
PRAKENREE, Nuanjan
PRASERTSOM, Piyada
PRATIWI, Endah D.
PRIASTOMO, Yoga
PUATRAKUL, Anong

94
100, 182, 203
140
90
187
203
158
158
119
110, 154180
82, 137
96
196
170

Q
QUAH, Anne Chiew Kin
QUAH, Anne C.K.
QUAH, Anne Chiew Kin

79, 96, 99, 112, 157, 169, 170, 195, 201
194
173

R
RABE, Gwen L.
RAHMAN, Syeda Anonna
RAHMAN, Taifur
RAHMAYANTI, Nurul M.
RĂKŎCZI, Ildikŏ
RAMLY, Zarina
RANA, Jugdeep S.
RANI, Noor A. A.
RANI, Noor Afiza Abd.
RARICK, JamesRASHID, Sazaroni Md.
RASOOL, Aida H. GHULAMRATANACHEA, Sophapan
RATTANAMONGKOLGUL, Suthee
RAUNGSIT, Kwanpat
RAUTE, Lalit J.
RAZZAK, Abdur R.
REDDY, K Srinath
REDMON, Pamela B.
REID, Jessica L
REID, Jessica L.
RESNICOW, Ken
REVANKAR, Dattatreya R.
REYES, Irene Patricia N.
REYES, Jennie L.
RICE, Wendy M.
RITTHIPHAKDEE, Bungon
ROSEMARY, Rizanna
ROSS, Hana
RUBAEAH
RUJIPORN, Prapon
RUKSAKUN, Kanjanee

94
119123, 206
195
127, 148
161
133
112
201
130
201
85
103, 107, 124
175
119
99
183
90
161
202
200
165
130
125, 200
103, 107, 124, 128
87
89, 127
134, 191
97, 204
88
117
153

RUNGRUANGHIRANYA, Suthat
RUSLIALDI, Mochamad A.
RUSSELL, Marie

175
189
101

S
SAENGNGERN, Sane148
SAFINA, Faizah
161, 186
SAID, Nora151
SAITO, Reiko91
SAITO, Urara177
SAITOH, Toshio
138
SAITOU, Haruna
164
SAKA, Hideo
155
SAKAI, Chiaki
179
SAKAMOTO, Akira
177
SAKATA, Ritsu
126
SAKATANI, Sawako
208
SAKUMA, Ichiro
141, 171
SAKURABA, Yuji
183, 188, 209
SAKURAI, Masayuki
171
SAKUTA, Manabu
76
SALIMAN, KHAIRUNISA184
SAMET, Jonathan M.
127
SAMIN, Ahmad Shalihin Mohd
79, 96, 173, 201
SAMSUDIN, Sulastri
112
SANIP, Zuikefli
141
SANSONE, Genevieve
99
SANTOS, Cecilia B.
153
SASAKI, Fumiaki
145
SASAKI, Kana
142
SASAKI, Keigo
81
SATITVIPAWEE, Pratana
200, 203
SATO, Kazuki
174
SATO, Masami
165
SATO, Natsuko
171
SATOH, Katashi
80
SATOMI, Daisuke
156
SATOMURA, Kazunari
120
SATSUE, Siranee
140
SEBASTIAN, Wulan A.
134
SEBAYANG, Susy K.
134
SEE, Kay Choong
151
SEKIGUCHI, Masatoshi
78
SELANON, Suksan
188
SENADISAI, Supanee
152, 154, 153
SENCZUK-PRZYBYLOWSKA, Monika A.
83
SENO, Ekuko
171
SEO, Hong Gwan
76, 170, 194, 195, 198, 202, 207
SERASART, Soontorn
189
SETH, Sanjay
99, 111, 128
SETYONALURI, Diahhadi
204
SEWALI, Barrett
165
SEZAI, Izumi
172
SHAH, Vandana
99, 111, 128
SHAMIM, Rashedujjaman
119

219

SHANG, Ce
SHARIF, Khartika M.
SHARMA, Deepak
SHARMA, Narender
SHEDGE, Hemlata
SHIDARA, Takuya
SHIGETA, Masako
SHIMADA, Kazunori
SHIMADA, Sayaka
SHIMADA, Sayaka
SHIMAI, Sakiko
SHIMAO, Tadao
SHIMATSU, Akira
SHIMATSU, Akira
SHIMIZU, Takahiro
SHIMOUCHI, Akira
SHIMOZONO, Masako
SHOUDA, Masataka
SIAHPUSH, Mohammad
SIKDER, Arif
SILPASUWAN, Pimpan
SINGH, Arvind
SINGH, Pramil N.
SINGH, Rana J
SINGH, Rana J.
SINGH, Rana J.
SINGH, Tarkeshwar Prasad
SINGH, Virendra
SIREGAR, Mara O.
SIRICHOTIRATANA, Nithat
SIRIRASSAMEE, Buppha
SIRIRASSAMEE, Tawima
SO, Anthony D.
SOMPOPCHAROEN, Malinee
SONG, Jun
SONO, Hajime I.
SONO, Jun
SONREXA, Juhi
SPIRES, MarkSRIMORAGOT, Pongsri
SRININGSIH, Wiwin
STILLMAN, Frances
STOKLOSA, Michal
STONE, Prudence
STUMBERG, Robert
SUGISAKI, Tomio
SUGISHITA, Mihoko
SUGITA, Hironobu
SUH, Mee-Kyung
SUHADI, Dollaris R.
SUHAIMI, Siti Syafiqah
SUHAIMI, Zulhusni
SUJIRARAT, Dusit
SUO, Chao
SURANI, Nikita

220

80, 98, 194
176
122
192, 198
200
183, 188, 209
103, 134, 135, 150, 151, 152,
156, 177, 179, 197, 206, 210, 211
84
138
140
143
147
138
140
157
89
211
190
80
131
200, 203111
124
88
179, 198
192
111
99
132
200, 203
91, 112, 118, 143, 144, 189, 210
118, 189, 210
107, 202, 204
200, 203
192
130
130
90
127
146, 154
196
127
204
117
203
145
155
147
135
132
184
141
200, 203
193, 207
100

SUTTON, Nicole
SUTTON, Nicole M.
SUWANRATSAMEE, Sangduean
SUWANTON, Lerson
SUZUKI, Fumiaki
SUZUKI, Hirofumi
SUZUKI, Kenji
SUZUKI, Maki
SUZUKI, Shuichi
SUZUKI, Takahiro
SY, Deborah
SZYFTER, Krzysztof
SZYFTER, Witold

211
111
187
140
149
177
209
171
174
186
106, 203
83
83

T
TACHIKAWA, Noriko
TAGAWA, Hitoshi
TAHIR, M Nazri M.
TAKAAKI, JunpeiTAKÁCS, Peter
TAKADA, Miyako
TAKAGI, Keigo
TAKAGI, Shigeto
TAKAHASHI, Masayuki
TAKAHASHI, Mayumi
TAKAHASHI, Misato
TAKAHASHI, Muneyoshi
TAKAHASHI, Rumi
TAKAHASHI, Yuko
TAKAHASHI, Yuko
TAKAHATA, Hiromi
TAKAI, Yujiro
TAKAISHI, Yoshihiro
TAKAMI, Yoji
TAKAYANAGI, Kyoko
TAKEBE, Kotaro
TAKEMI, Keizo
TAKEMOTO, Fumiro
TAKESHITA, Naoko
TAMBE, Jayshali B.
TAMPLIN, Stephen
TAMURA, Hiroshi
TAN, Yen LianTANABE, Satoshi
TANAKA, Etsuko
TANAKA, Hideo
TANAKA, Ikuko
TANAKA, Mai
TANAKA, Mai
TANAKA, Mieko
TANAKA, Yoshitsugu
TANAMURA, Masako
TANGCHAROENDEE, Nontinee
TANIGUCHI, Chie
TANIGUCHI, Chie

83
147
201
152
148
152
144
190
147, 171
164
164
206
164
138
140
164
144
129
156
147
177
73
130
162
175, 181
127
164
101, 104, 127, 202
150
171
155
150
191
193
183, 188, 208, 209
134, 135
129
137
155
176

TANIGUCHI, Mihoko
TANIMURA, Masako
TARADOLRATANAKORN, A.
TARUMI, Yosuke
TAUTOLO, El-Shadan
TAYLOR, SteveTAYYAN, ÜnalTECHASIRIKOSOL, Paungthong
TEERASIRIROJ, Tippawan
TERADA, Rumiko
TERADA, Tetsuya
TERAKAWA, Kazuhiko
TERASHIMA, Sachiko
TEWARI, AbhaTEZUKA, Naoko
THAVEERATITHAM, Premtip
THAWAL, Vaibhav
THOMAS, Blesson
THOMAS, Janet L.
THOMPSON, Mary
THOMPSON, Mary
THOMSON, George
THONGNUN, Wantanee
THRASHER, Jim F.
TIEN, Pei Wen
TODA, Hiroko
TOMOTA, Shinji
TORII, Sayuki
TORPRADIT, R.
TOSHIMITSU, Yasuko
TOWNSEND, Joy
TOYODA, Yasuyoshi
TOYOSHIMA, Hiroko
TOYOTA, Shigeki
TRINIDAD, Florante E.
TRUNIN, Ilya
TRYCHASIRIKOSOL, Pougthong
TSAI, Min-Kuang
TSUBURA, Shuichi
TSUNO, Satoshi
TSUTSUMI, Miyuki
TU, Ming-Shium
TU, Ming-Shium
TUN, Aung
TUNTIWITAYAPAN, Somkid
TURAN, Muzaffer O.
TURAN, Pakize A.
TUÚTAFAIVA, Siosifa Tuitupou

132, 142, 143
118
90
177
208
79, 132
75
119
161
150
147
89
140
90
147
117, 162
100
188
165
79, 80, 96, 105, 194
173
79, 101, 132
119, 180, 187
105
185
130
177
152
90
156
204
156
179
130
121, 15375
180
80, 138, 157
138
167
164
159
162
174, 207
148
79
79
74

U
UEDA, Miho
UOZUMI, Kimiko
URBAN, Robert
USUI, Yohsuke
UTOMO, Waras BUDI

152
176
181
208
112

UTRAVATHY, Vasuki

176

V
VACHIRAROJPISAN, Thongchai
VATHESATOGKIT, Krongjit
VATHESATOGKIT, Prakit
VEERASUKSAWATT, Ratchanee
VILLARREIZ, Domilyn
VIROONUDOMPHOL, Duangkamol
VISALSETH, Wikul
VITAVASIRI, Chanthana
VIWATWONGKASEM, Chukiat
VONGPHOSY, Maniphanh

182
181
72
180
87
140
182
90, 180
200, 203
124

W
WADA, Hiromichi
WADA, Hiromichi
WAN, Xia
WANCHAI, Areepan
WANG, Chen
WANG, Miranda
WANG, Tsu-Shing
WANG, Xinhui
WATANABE, Hiroko
WATANABE, Isao
WATANABE, Naoto
WATANABE, Sayuri
WATANABE, Yoshiko
WATANABE, Yoshiyuki
WATI, Erna
WEERAPRADIST, Woranut
WEISS-GERLACH, Edith
WELLMANN, Juergen
WEN, Chi-Pang
WHYTE, Gregor
WILSON, Nick
WISALSETH, Wikul
WIYONO, Nurhadi
WONG, ChristineWOZNIAK, Anna M.
WU, Changbao
WU, Shiuan Be
WU, Yiqun
WUAN, Chang Yin

138
140
127
187
85
102, 198
84
167
174
103, 135, 152, 156, 197, 206, 210
81
162
193
151, 152, 156, 206, 210
112
82
94
94
80, 138, 157
105, 109, 145
79, 101, 132, 185
137
136, 183, 204
78, 9383
170
80, 138, 157
102, 198
158

X
XIAO, DanXIAO, LinXU, Guihua

85
201
111, 193

Y
YAMADA, Keiko

133

221

YAMADA, Keiko
YAMADA, Nobuhisa
YAMAGAMI, Risa
YAMAGUCHI, Yukinobu
YAMAKADO, Katsura
YAMAKAGE, Hajime
YAMAKAGE, Hajime
YAMAMOTO, Kaisuke
YAMAMOTO, Ryuichiro
YAMANA, Midori
YAMAOKA, Masaaki
YAMASHIRO, Hiroshi
YAMASHITA, Mika
YAMATO, Hiroshi
YAMAUCHI, Yuko
YAMAZAWA, Hitomi
YAN, Lin
YAN, Mi
YANG, Gonghuan
YANG, Jilan
YANG, Pei-Kan
YANG, Yi
YANO, Naoko
YASUDA, Sakiko
YASUDA, Yuji
YAU, Sea- Wain
YE, Xiao-hua
YEE, Nan Hee
YEL, Daravuth
YETAPU, Vijay B.
YOKOTA, Shohei
YONEUCHIYAMA, Satsuki
YONG, Hna-Hie
YONG, Hua
YONG, Hua-Hie
YONG, Pei C.
YOON, Ji Eun
YOSHIDA, Junichi
YOSHIHARA, Shin
YOSHII, Chiharu
YOSHII, Chiharu
YOSOFF, Harmy MOHAMED
YOUTH, Apact
YU, Li-Hui
YUAN, Jiang
YUKAWA, Ken
YUREKLI, Ayda
YUSOFF, Harmy MOHAMAD

143
142
80
176
152
138
140
156
209
166
99, 149
157
179
86, 132, 133, 142
88
150
88
195
127, 199
110
109
177
190
133
103, 134, 197
135, 136
177
148
124, 197
169, 210
179
171
105
201
169
163
100
145
206
159, 160, 166
176
184
113
143
202
83
74, 98, 107, 122
85, 141Z
ZABIT, Aisyah Aliana MOHDZAHRA, Nahleen
ZAIN, Zarihah
ZHANG, Chunmei
ZHANG, Xiaochang

222

184
98
201
85
127

ZHAO, NaZHAO, PingZHENG, RongZOU, Xiao-nong

150
169120, 122
169

第8回

The 8thAnnual Conference of the Japan Society for Tobacco Control

日本禁煙学会学術総会

2014年

11月15日 土 16日 日

Duration: November 15-16 , 2014

沖縄コンベンションセンター
Venue: Okinawa Convention Center〒 901-2224 沖縄県宜野湾市真志喜 4-3-1

会長

日本禁煙学会認定単位（１）
学術総会出席（２）
学術総会発表（３）
禁煙治療セミナー出席

10単位
10単位
10単位

禁煙サポーター認定（１）
学術総会出席（２）
禁煙治療セミナー出席

山代 寛 沖縄大学人文学部福祉文化学科教授
President: Hiroshi Yamashiro

http://jstc8th.nosmoke55.jp/■事務局
沖縄ニコチン依存症研究会事務局 沖縄大学地域研究所〒902-8521 沖縄県那覇市国場555番地
TEL・FAX：098-993-7995
E-mail：jstc2014@okinawa-u.ac.jp

主催■運営事務局株式会社 沖縄コングレ内〒900-0015沖縄県那覇市久茂地３−１−１ 日本生命那覇ビル
TEL 098-869-4220 FAX 098-869-4252
E-mail: jstc2014@okicongre.jp

特定非営利活動法人日本禁煙学会

Toward a TB-free World

結核のない世界へ

Japan Anti-Tuberculosis Association ( JATA ) is a public corporation.
We has been expanding our activities by conducting theoretical andClinical research on lung cancer and other respiratory diseases.
結核予防会は公益財団法人です。
結核に加えて呼吸器疾患対策等にも取り組んでいます。

Tuberculosis
結核International
Cooperation
国際協力

Respiratory
diseaseLifestyle relateddisease

呼吸器疾患対策

生活習慣病対策JATA
MISSION
基本方針

Japan Anti-Tuberculosis Association

公益財団法人結核予防会

1-3-12, Misakicho, Chiyodaku, Tokyo, 101-0061 Japan〒101-0061東京都千代田区三崎町1-3-12
Phone 81-3-3292-9211 Fax 81-3-3292-9208
電話 03-3292-9211 Fax 03-3292-9208
e-mail fukyu@jatahq.org
URL http://www.jatahq.org/

新しい学び、新たな出会い

www.miraijyuku.com

NPO 法人 未来塾
塾長 深田甫（慶応義塾大学名誉教授）【講師陣・順不同】
深田甫（ドイツ文学）池田博（聖書）中野義人（平家物語）玉井幸久（漢詩）中田秀光（漢字学）
森照雄（竹細工）木場田強（俳句）永山宗幸（茶道）原田紅倫（書道）真山誠（そば打ち）細沼みえ（声楽）藤田忠弘（謡曲）岡信光（囲碁）廣石陽子（英会話）浜ゆたか（演歌）星隈くるみ（ピアノ）垣見久子（油絵）野仲加津子（着付、体操）栗原明子（ピアノ）福居寛美（デジカメ）大河寛理（日舞）糠沢留美子（合唱）金子勝（詩吟）塩月安朗（囲碁）稲垣惠子（声楽）千原友子（ヴァイオリン）田中睦子（社交ダンス）
関口照雄（絵手紙）田中初芽（ピアノ）土橋小夜子（水彩画）大山浩朗（造園、英文学）金子敦（俳句）高橋栖子（ピアノ）鈴木則子（合唱）加山宗直（茶道）田中由美子（ピアノ）勝又飛岳（そば打ち）
原田直眞紗（民謡）野寄眞砂子（太極拳）郭永美（韓国語）永戸美津子（淡彩画）下條世津子（和太鼓）関口正俊（昭和史、時事評論、奥の細道、囲碁）【事務局】〒247-0005
TEL:045-719-0882

横浜市栄区桂町 158-7-102

FAX:045-892-1200

E-mail:m-sekiguti@nifty.com

We are supporting prohibition-of-smoking-ization of the area.

Togenuki Jizo Koganji Temple“Splinter-extracting Buddha”
禁煙は愛

Tobacco-free & AED-ready
Buddhist Temple
in Toshima Ward Tokyo Japan

Main Hall

とげ

煙草をぬいて健康長寿！
タバコ

Approach
Approach toto Main
Main Gate
Hall

とげぬき地蔵尊 高岩寺

170-0002 豊島区巣鴨 3-35-2 ☎03-3917-8221

MEMO

The 10th APACT Conference

ISSN 1883-2970

the Tobacco Epidemic
The 10th APACT Conference –Ending
Protecting and Keeping Healthy Lives –Ending the Tobacco Epidemic– Protecting and Keeping Healthy Lives –Program and Abstract Book
In collaboration with the 7th annual conference of
the Japan Society for Tobacco Control

Program and Abstract Book

August 18 - 21, 2013
Makuhari Messe, Chiba, Japan

http://www.apact.jp/